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Aspirin resistance was less common in patients taking low-dose aspirin.
Results of a small prospective study suggest that almost half of patients hospitalized for treatment of ischemic stroke or transient ischemic attack (TIA) are "aspirin resistant" as defined by an abnormal finding on PFA-100 (platelet function analyser) testing.
Dr. Mark Alberts, of Northwestern University Medical School, Chicago, reported at the 5th World Stroke Congress that 47% of such patients demonstrated aspirin resistance which was defined as a clotting time of 171 seconds or less.
The study involved 59 patients (mean age 64 years) who had been taking aspirin for at least 3 days prior to an acute event. The PFA-100 testing was done at the time of hospital diagnosis, before any loading dose of antiplatelet therapy.
The machine measures the clotting time of a blood sample that is pumped through a collagen coated membrane, a test design that mimics the behavior of circulating blood. The test results, Dr. Alberts said, are available in "about 5 minutes and the test costs only $15 to $20."
Sixty-three percent of patients were taking 325 mg/day of aspirin, and 37% were using 81 mg. Aspirin resistance was less common in patients taking low-dose aspirin. Results were normal in 73% of such the patients versus 32% of patients taking high dose aspirin (p<0.005).
There also was a trend towards more resistance in patients taking enteric-coated aspirin compared to uncoated aspirin (73% versus 39%).
The results suggest that "dose-adjusted antiplatelet therapy is where the field is heading," Dr. Alberts concluded. "One size fits all therapy doesn’t work for aspirin."
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