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COMMENTS AND OPINIONS
Laboratory-Defined Aspirin Resistance and Recurrent Cardiovascular Events
Pierre Fontana, MD, PhD;
Jean-Luc Reny, MD, PhD
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In their meta-analysis, Snoep et al1 found that "laboratory-defined aspirin resistance" was associated with an increased risk of recurrent cardiovascular events in aspirin-treated patients. However, this conclusion is undermined by a significant heterogeneity test result, even when using a random effects model. The authors included studies with very different designs and particularly different definitions of "aspirin resistance." Indeed, the biological tests used in the selected studies were either specific for aspirin inhibition of thromboxane (Tx)A2 synthesis (measurement of TxB2 levels or of arachidonic acid–induced platelet aggregation) or nonspecific (eg, template bleeding time or the Platelet Function Analyzer100 [Dade Behring, Deerfield, Illinois]).
Specific and nonspecific tests are drastically different, since the latter are not directly related to the effect of aspirin.2 Indeed, TxA2 is similarly inhibited by aspirin in subjects who are considered "aspirin resistant" and "aspirin responders" on the basis of nonspecific . . . [Full Text of this Article] AUTHOR INFORMATION
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Association of Laboratory-Defined Aspirin Resistance With a Higher Risk of Recurrent Cardiovascular Events: A Systematic Review and Meta-analysis
Jaapjan D. Snoep, Marcel M. C. Hovens, Jeroen C. J. Eikenboom, Johanna G. van der Bom, and Menno V. Huisman
Arch Intern Med. 2007;167(15):1593-1599.
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