The pre- and postoperative prevalence and risk factors of ASA nonresponse in vascular surgery

BackgroundAn antiplatelet therapy with acetylsalicylic acid (ASA) is prescribed in the prevention of cardiovascular events, but around 24% of ASA takers are resistant to the treatment.AimIn this prospective, observational cohort study, we aimed to identify the prevalence and risk factors of ASA nonr...

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Hauptverfasser: Kazimi, Alia Uzra (VerfasserIn) , Weber, Christian Friedrich (VerfasserIn) , Keese, Michael (VerfasserIn) , Miesbach, Wolfgang (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: October 5, 2021
In: Clinical and applied thrombosis, hemostasis
Year: 2021, Jahrgang: 27, Pages: 1-7
ISSN:1938-2723
DOI:10.1177/10760296211044723
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1177/10760296211044723
Volltext
Verfasserangaben:Alia Uzra Kazimi, MD, Christian Friedrich Weber, MD, Michael Keese, MD, and Wolfgang Miesbach, MD

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520 |a BackgroundAn antiplatelet therapy with acetylsalicylic acid (ASA) is prescribed in the prevention of cardiovascular events, but around 24% of ASA takers are resistant to the treatment.AimIn this prospective, observational cohort study, we aimed to identify the prevalence and risk factors of ASA nonresponse in patients who underwent vascular surgery.MethodsThe study was conducted in the University hospital in Frankfurt am Main. In total, 70 patients were pre-treated with 100?mg of ASA per day and underwent either elective carotid thromboendarterectomy, femoral thromboendarterectomy or endovascular aneurysm repair of the abdominal aorta. The platelet function was measured on the first preoperative and the second or fourth postoperative day with the multiple electrode aggregometry by in-vitro stimulation with arachidonic acid (ASPItest) and thrombin receptor activating peptide 6 (TRAPtest). The primary end point was the in-vitro induced platelet aggregation in the ASPItest. If the ASPItest amounted ≥400 AU???min, the patients were categorized as ASA nonresponders.ResultsThe total prevalence of ASA nonresponse in our study was 20% preoperatively and 35.7% postoperatively (p?=?0.005). As significant predictors for ASA nonresponse, we demonstrated the area under the aggregation curve in the TRAPtest preoperatively (p?=?0.04) and postoperatively (p?=?0.02), and the two comorbidities arterial hypertension (P? 
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