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One-Fourth Found Non-Responsive to Aspirin, Risk
Cardiac Events
July 26, 2005 – Must research shows that aspirin
can help prevent a heart attack or stroke, but does aspirin work equally
well for everyone? A growing amount of medical evidence says no. One
reason emerging to explain this difference is that some people fail to
achieve an adequate response to the drug. A new study adds weight to
that theory, showing that lack of response to aspirin therapy greatly
increases the risk of serious cardiovascular complications.
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The study, conducted at the University of Hong
Kong, found that fully 25 percent of the 422 patients were aspirin
non-responders. The subjects were followed for an average of about 11
months to determine how their response to aspirin affected the risk of
cardiac events. Researchers found that patients with an inadequate
response to aspirin were more than twice as likely to have a heart
attack or stroke, be admitted to the hospital for chest pain, or die,
compared to patients who had a therapeutic response to aspirin.
The research results were presented at the annual
meeting of the American Association of Clinical Chemistry (AACC), taking
place this week in Orlando, Florida.
"These are important findings," said Alan Maisel,
professor of medicine at the University of California, San Diego, and a
researcher in the field of cardiac outcomes. "It adds to the growing
amount of evidence documenting the consequences of aspirin failure, and
shows that non-responsive patients are indeed at significantly greater
risk for potentially life-threatening events."
Several factors were associated with a poor
response to aspirin. Most notably, women were much more likely to be
aspirin non-responders. Another factor was taking a lower dose of
aspirin.
"The finding that aspirin non-response is more
common among women is particularly interesting in light of information
released recently from the Women's Health Study," said Daniel Simon, MD,
associate director of interventional cardiology at Brigham and Women's
Hospital in Boston. "That study indicated that women often do not
benefit from aspirin to the same extent that men do. This new research
points to one possible explanation for the disparity, namely, that women
are less likely to achieve a therapeutic response to aspirin. This
presents an intriguing direction for further exploration."
Aspirin response in the AACC study was evaluated
using the VerifyNow(TM) System, a rapid, easy to perform blood test that
assesses platelet function. Inhibition of platelet function is how
aspirin exerts its cardioprotective effects. The VerifyNow test gives
one, easy to understand result that indicates if a person is responding
effectively to aspirin or if they are not.
"One of the major implications of this research is
that we need to be paying more attention to the dose of aspirin that
patients are taking," Dr. Maisel added. "For patients who do respond to
low doses, that's great. We can confidently keep them on that dose
without risking bleeding complications. But for patients who don't
respond, higher doses are warranted to ensure that they are adequately
protected. Testing aspirin response is a pivotal element of this
clinical decision-making and now for the first time we have a practical,
office-based test that has been shown to correlate with clinical
outcomes."
About Accumetrics (www.accumetrics.com)
Accumetrics develops, manufactures,
and markets the VerifyNow(TM) System, a comprehensive system for the
assessment of platelet function. Modulation of platelet function plays a
critical role in effectively treating cardiovascular, cerebrovascular,
and peripheral vascular disease. VerifyNow is the only rapid platelet
function test shown to correlate with clinical outcomes. The tests
provide doctors with an easy to use, automated, rapid and accurate way
to monitor platelet function to optimize the effectiveness of
antiplatelet therapies and to guide treatment decisions in patients who
may be at risk of bleeding complications. Accumetrics markets
VerifyNow(TM) assays for aspirin and GP IIb/IIIa inhibitors, and expects
to introduce a new test for P2Y12 inhibitors such as clopidogrel (Plavix(R))
later this year.
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