Key result
Inadequate platelet aggregation inhibition to aspirin (10.6% of patients) was significantly associated with the composite end point of death, myocardial infarction, or stroke.
Why the study?
Definite recommendations for platelet aggregation testing in ACS are lacking because evidence on using platelet function tests to guide therapy and improve clinical outcomes remains inconclusive.
Does evaluation of platelet aggregation using multiple electrode impedance aggregometry predict adverse clinical outcomes in patients with acute coronary syndromes?
Observational (n=47)
No
Does evaluation of platelet aggregation using multiple electrode impedance aggregometry predict adverse clinical outcomes in patients with acute coronary syndromes?
Answers are grounded in this paper and cite their sources.
Evaluation of platelet aggregation using multiple electrode impedance aggregometry may identify non-responders to aspirin who are at higher risk for adverse clinical outcomes following acute coronary syndromes.
There is no definite recommendation for testing platelet aggregation (PA) in acute coronary syndromes (ACS) due to inconclusive evidence on the usefulness of platelet function tests to guide therapy and improve clinical outcomes. The evaluation of PA with multiple electrode impedance platelet aggregometry (MEA) may be useful to manage antiplatelet therapy and possibly influence patient outcome. The primary aim of this study was to measure PA with MEA in Brazilian patients with ACS and evaluate the association between PA and adverse clinical outcomes. Forty-seven consecutive patients admitted with ACS to a Brazilian tertiary-care public hospital were studied and PA was evaluated using MEA. Patients were followed for six months for the occurrence of all-cause death, acute myocardial infarction, or stroke. Suboptimal inhibition of PA was found in 7 patients (14.9%); 5 (10.6%) in response to ASA (acetylsalicylic acid), 2 (5.0%) to clopidogrel, and none to ticagrelor. Inadequate PA inhibition in response to ASA was significantly associated with the composite end point, but there was no significant association for insufficient PA inhibition in response to clopidogrel. This study suggested that the evaluation of PA in ACS using MEA may identify non-responders to ASA. Larger studies are necessary to define, in a public health scenario, the value of MEA in the management of ACS.
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Lorenzo et al. (2019) conducted an observational in Acute coronary syndromes (n=47). Inadequate platelet aggregation inhibition in response to aspirin vs. Adequate platelet aggregation inhibition was evaluated on Composite of all-cause death, acute myocardial infarction, or stroke. Inadequate platelet aggregation inhibition to aspirin (10.6% of patients) was significantly associated with the composite end point of death, myocardial infarction, or stroke.
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