Antiplatelet Effect of Aspirin in Patients with Cerebrovascular Disease

Mark J. Alberts, Deborah L. Bergman, Elise Molner, Borko D. Jovanovic, Issei Ushiwata, Jun Teruya

Research output: Contribution to journalArticle

175 Citations (Scopus)

Abstract

Background and Purpose-Aspirin is used commonly to prevent ischemic strokes and other vascular events. Although aspirin is considered safe and effective, it has limited efficacy with a relative risk reduction of 20% to 25% for ischemic stroke. We sought to determine if aspirin as currently used is having its desired antiplatelet effects. Methods-We ascertained patients with cerebrovascular disease who were taking only aspirin as an antiplatelet agent. Platelet function was evaluated using a platelet function analyzer (PFA-100). PFA test results were correlated with aspirin dose, formulation, and basic demographic factors. Results-We ascertained 129 patients, of whom 32% were taking an enteric-coated aspirin preparation and 32% were taking low-dose (≤162 mg/d) aspirin. For the entire cohort, 37% of patients had normal PFA-100 results, indicating normal platelet function. For the patients taking low-dose aspirin, 56% had normal PFAs compared with 28% of those taking ≥325 mg/d of aspirin, while 65% of patients taking enteric-coated aspirin had normal PFAs compared with 25% taking an uncoated preparation (P<0.01 for both comparisons). Similar results were obtained if PFA results were analyzed using mean closure times (low-dose aspirin, 183 sec; high-dose aspirin, 233 sec; enteric-coated, 173 sec; uncoated, 235 sec; P<0.01 for comparisons). Older patients and women were less likely to have a therapeutic response to aspirin, independent of aspirin dose or formulation. Conclusions-A significant proportion of patients taking low-dose aspirin or enteric-coated aspirin have normal platelet function as measured by the PFA-100 test. If these results correlate with clinical events, they have broad implications in determining how aspirin is used and monitored.

Original languageEnglish (US)
Pages (from-to)175-178
Number of pages4
JournalStroke
Volume35
Issue number1
DOIs
StatePublished - Jan 2004

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Cerebrovascular Disorders
Aspirin
Blood Platelets
Stroke
Platelet Aggregation Inhibitors

Keywords

  • Antiplatelet therapy
  • Aspirin
  • Cerebrovascular disorders
  • Stroke, ischemic

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

Cite this

Alberts, M. J., Bergman, D. L., Molner, E., Jovanovic, B. D., Ushiwata, I., & Teruya, J. (2004). Antiplatelet Effect of Aspirin in Patients with Cerebrovascular Disease. Stroke, 35(1), 175-178. https://doi.org/10.1161/01.STR.0000106763.46123.F6

Antiplatelet Effect of Aspirin in Patients with Cerebrovascular Disease. / Alberts, Mark J.; Bergman, Deborah L.; Molner, Elise; Jovanovic, Borko D.; Ushiwata, Issei; Teruya, Jun.

In: Stroke, Vol. 35, No. 1, 01.2004, p. 175-178.

Research output: Contribution to journalArticle

Alberts, MJ, Bergman, DL, Molner, E, Jovanovic, BD, Ushiwata, I & Teruya, J 2004, 'Antiplatelet Effect of Aspirin in Patients with Cerebrovascular Disease', Stroke, vol. 35, no. 1, pp. 175-178. https://doi.org/10.1161/01.STR.0000106763.46123.F6
Alberts, Mark J. ; Bergman, Deborah L. ; Molner, Elise ; Jovanovic, Borko D. ; Ushiwata, Issei ; Teruya, Jun. / Antiplatelet Effect of Aspirin in Patients with Cerebrovascular Disease. In: Stroke. 2004 ; Vol. 35, No. 1. pp. 175-178.
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AB - Background and Purpose-Aspirin is used commonly to prevent ischemic strokes and other vascular events. Although aspirin is considered safe and effective, it has limited efficacy with a relative risk reduction of 20% to 25% for ischemic stroke. We sought to determine if aspirin as currently used is having its desired antiplatelet effects. Methods-We ascertained patients with cerebrovascular disease who were taking only aspirin as an antiplatelet agent. Platelet function was evaluated using a platelet function analyzer (PFA-100). PFA test results were correlated with aspirin dose, formulation, and basic demographic factors. Results-We ascertained 129 patients, of whom 32% were taking an enteric-coated aspirin preparation and 32% were taking low-dose (≤162 mg/d) aspirin. For the entire cohort, 37% of patients had normal PFA-100 results, indicating normal platelet function. For the patients taking low-dose aspirin, 56% had normal PFAs compared with 28% of those taking ≥325 mg/d of aspirin, while 65% of patients taking enteric-coated aspirin had normal PFAs compared with 25% taking an uncoated preparation (P<0.01 for both comparisons). Similar results were obtained if PFA results were analyzed using mean closure times (low-dose aspirin, 183 sec; high-dose aspirin, 233 sec; enteric-coated, 173 sec; uncoated, 235 sec; P<0.01 for comparisons). Older patients and women were less likely to have a therapeutic response to aspirin, independent of aspirin dose or formulation. Conclusions-A significant proportion of patients taking low-dose aspirin or enteric-coated aspirin have normal platelet function as measured by the PFA-100 test. If these results correlate with clinical events, they have broad implications in determining how aspirin is used and monitored.

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KW - Cerebrovascular disorders

KW - Stroke, ischemic

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