Key result
Aspirin resistance was present in 6.67% of aspirin-compliant CHD patients following TPVR, and while all resistant cases were female, thromboembolic events did not correlate with resistance.
Why the study?
Aspirin is often prescribed long-term after TPVR to prevent thromboembolic events, but the prevalence of aspirin resistance in this CHD population was unknown.
What is the prevalence of aspirin resistance and its association with thromboembolic events in congenital heart disease patients following transcatheter pulmonary valve replacement?
Observational (n=48)
What is the prevalence of aspirin resistance and its association with thromboembolic events in congenital heart disease patients following transcatheter pulmonary valve replacement?
Aspirin resistance is present in a small subset of CHD patients post-TPVR, predominantly females, but does not appear to correlate with an increased risk of thromboembolic events.
Answers are grounded in this paper and cite their sources.
Low aspirin resistance prevalence without higher events post-TPVR; leaves open need for larger studies before testing or regimen changes.
BACKGROUND: Congenital heart disease (CHD) patients with pulmonary valve failure may undergo transcatheter pulmonary valve replacement (TPVR). Aspirin is often prescribed as long-term therapy after TPVR to prevent thromboembolic events (TE). AIMS: We aimed to examine the prevalence of aspirin resistance within the CHD TPVR population. METHODS: The VerifyNow point-of-care test quantifies platelet aggregation as Aspirin Reactivity Units (ARU). ARU values greater than 550 suggest aspirin resistance (AR). A retrospective chart review analyzed ARU test results from May 2022 through December 2023 in CHD patients following successful TPVR (n = 48). Lifelong TE history was collected. Association between AR and sex, race, and ethnicity was examined with Fisher's Exact test, and the Wilcoxon rank sum exact test analyzed associations between AR and age. RESULTS: Three of 45 (6.67%) CHD TPVR aspirin-compliant patients (average age 33.14 years; range 0.74-77.86 years, 47% females) were AR. Interestingly, all AR patients were females, suggesting higher AR prevalence in females (p = 0.094). No significant associations were found between AR and age (p = 0.8), race (p = 0.077), or ethnicity (p = 0.2). No AR patients had a documented history of TE. Five of 42 (11.9%) aspirin sensitive patients had TE while taking aspirin, including two females (not on birth control at time of event) and three males. CONCLUSIONS: AR is prevalent in CHD TPVR patients, but TE occurrence did not correlate with AR. However, AR exclusively in females and TE in aspirin sensitive patients, suggests need for further investigations on the most effective TE prophylaxis in this population.
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Sigman et al. (2025) conducted an observational in Congenital heart disease following transcatheter pulmonary valve replacement (n=48). Aspirin resistance vs. Aspirin sensitivity was evaluated on Prevalence of aspirin resistance. Aspirin resistance was present in 6.67% of aspirin-compliant CHD patients following TPVR, and while all resistant cases were female, thromboembolic events did not correlate with resistance.
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