A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients

Aspirin is an anti-platelet agent used to prevent thrombo-embolic complications related to coronary artery disease. It is currently the most cost effective drug for the secondary prevention of coronary artery disease, but treatment failures are relatively common. The tenn aspirin resistance has b...

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Main Author:	Sanada, Abu Bakar
Format:	Thesis
Language:	English
Published:	2008
Subjects:	R Medicine (General)
Online Access:	http://eprints.usm.my/52398/1/DR.%20ROHANA%20BINTI%20ABDUL%20RASHID%20-%2024%20pages.pdf
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spelling	my-usm-ep.523982022-04-24T01:46:17Z A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients 2008 Sanada, Abu Bakar R Medicine (General) Aspirin is an anti-platelet agent used to prevent thrombo-embolic complications related to coronary artery disease. It is currently the most cost effective drug for the secondary prevention of coronary artery disease, but treatment failures are relatively common. The tenn aspirin resistance has been used to describe not only an absence of the expected phannacologic effects of aspirin on platelets but also poor clinical outcomes, such as recurrent vascular events and sudden death. By studying the platelet function, the anti platelet effects of aspirin can be assessed. Traditional platelet function study as a gold standard was done by platelet aggregation method using PRP specimen. However, PRP preparation was laborious, need higher specimen volume and is non-physiological. This test however has established criteria for classification of aspirin sensitive and aspirin resistance status. Using whole blood specimen is less laborious; less specimen volume is needed and more physiological. The aims of this study were: 1) to determine the agreement between PRP and whole blood specimen using same platelet analyzer in stable coronary artery disease patients; 2) to compare the results between 2 whole blood methods using different platelet analyzer and 3) to study the laboratory and clinical characteristics of the patients classified as aspirin sensitive and aspirin resistance group. A cross sectional study of stable coronary artery disease patients attending Cardiology Clinic at HUSM was conducted in year 2006. Forty patients were analyzed using whole blood by Chronolog analyzer. Among these patients, they were also analyzed by 2 other different methods. Nine patients were analyzed using PRP by same Chronolog analyzer. Another 25 patients were analyzed using whole blood by Multiplate platelet function analyzer (new automated analyzer). Abnormal platelet aggregation induced by platelet agonist (AA and ADP) is expected in patients responding to aspirin( aspirin sensitive).The prevalence of aspirin resistance was 10% and 20% with Chronolog analyzer and Multiplate analyzer respectively. In this preliminary study, we found that both PRP and WB samples using Chronolog platelet aggregometer have a good agreement to categorize resistance status to aspirin. Higher detection of platelet resistance was seen by Multiplate analyzer than whole blood Chronolog platelet analyzer. There were no significant differences with regard to age, race, sex, smoking, hyperlipidemia, diabetes mellitus, hypertension and platelet count between aspirin sensitive and aspirin resistance groups. For laboratory parameters, abnormal ATP released with AA and ristocetin aggregation showed significant difference between aspirin resistance and responder group. 2008 Thesis http://eprints.usm.my/52398/ http://eprints.usm.my/52398/1/DR.%20ROHANA%20BINTI%20ABDUL%20RASHID%20-%2024%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	R Medicine (General)
spellingShingle	R Medicine (General) Sanada, Abu Bakar A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
description	Aspirin is an anti-platelet agent used to prevent thrombo-embolic complications related to coronary artery disease. It is currently the most cost effective drug for the secondary prevention of coronary artery disease, but treatment failures are relatively common. The tenn aspirin resistance has been used to describe not only an absence of the expected phannacologic effects of aspirin on platelets but also poor clinical outcomes, such as recurrent vascular events and sudden death. By studying the platelet function, the anti platelet effects of aspirin can be assessed. Traditional platelet function study as a gold standard was done by platelet aggregation method using PRP specimen. However, PRP preparation was laborious, need higher specimen volume and is non-physiological. This test however has established criteria for classification of aspirin sensitive and aspirin resistance status. Using whole blood specimen is less laborious; less specimen volume is needed and more physiological. The aims of this study were: 1) to determine the agreement between PRP and whole blood specimen using same platelet analyzer in stable coronary artery disease patients; 2) to compare the results between 2 whole blood methods using different platelet analyzer and 3) to study the laboratory and clinical characteristics of the patients classified as aspirin sensitive and aspirin resistance group. A cross sectional study of stable coronary artery disease patients attending Cardiology Clinic at HUSM was conducted in year 2006. Forty patients were analyzed using whole blood by Chronolog analyzer. Among these patients, they were also analyzed by 2 other different methods. Nine patients were analyzed using PRP by same Chronolog analyzer. Another 25 patients were analyzed using whole blood by Multiplate platelet function analyzer (new automated analyzer). Abnormal platelet aggregation induced by platelet agonist (AA and ADP) is expected in patients responding to aspirin( aspirin sensitive).The prevalence of aspirin resistance was 10% and 20% with Chronolog analyzer and Multiplate analyzer respectively. In this preliminary study, we found that both PRP and WB samples using Chronolog platelet aggregometer have a good agreement to categorize resistance status to aspirin. Higher detection of platelet resistance was seen by Multiplate analyzer than whole blood Chronolog platelet analyzer. There were no significant differences with regard to age, race, sex, smoking, hyperlipidemia, diabetes mellitus, hypertension and platelet count between aspirin sensitive and aspirin resistance groups. For laboratory parameters, abnormal ATP released with AA and ristocetin aggregation showed significant difference between aspirin resistance and responder group.
format	Thesis
qualification_level	Master's degree
author	Sanada, Abu Bakar
author_facet	Sanada, Abu Bakar
author_sort	Sanada, Abu Bakar
title	A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
title_short	A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
title_full	A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
title_fullStr	A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
title_full_unstemmed	A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
title_sort	pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2008
url	http://eprints.usm.my/52398/1/DR.%20ROHANA%20BINTI%20ABDUL%20RASHID%20-%2024%20pages.pdf
_version_	1747822173850959872

A pilot study on platelet response to aspirin with whole blood platelet aggregation methods in stable coronary artery disease patients

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