Use of the PFA-100 closure time to predict cardiovascular events in aspirin-treated cardiovascular patients: a systematic review and meta-analysis
نویسندگان
چکیده
Background: PFA-100 is a point-of-care assay that evaluates platelet reactivity in high-shear-stress conditions by measuring the closure time (CT) of a membrane aperture. When determined with a collagen/epinephrine cartridge (CEPI), the CT is usually prolonged by aspirin. Studies of the predictive value of a short PFA-100CTCEPI for ischemic events in aspirin-treated patients have given variable results. Objectives: To conduct a systematic review and metaanalysis of studies on the clinical predictive value of a short PFA-100CTCEPI in aspirin-treated cardiovascular patients. Patients and methods: Relevant studies were identified by scanning electronic databases. Studies were selected if they included aspirin-treated patients with symptomatic atherosclerosis,measured the PFA-100CTCEPI, used aCT cut-off value to define aspirin responders and non-responders , and reported ischemic events. Results: We selected seven nonprospective studies (1466 patients) and eight prospective studies (1227 patients). In non-prospective studies, the PFA100CTCEPI was performed after the ischemic clinical endpoint, and a publication bias was identified. In prospective studies, the global odds ratio (OR) for the recurrence of an ischemic event in aspirin non-responders relative to aspirin responders was 2.1 [95% confidence interval (CI) 1.4–3.4, P < 0.001]. Pooled analysis with a random effect model revealed no heterogeneity (Q Cochran P = 0.36 and I = 9.4%). Conclusions: A short PFA-100CTCEPI is associated with increased recurrence of ischemic events in aspirintreated cardiovascular patients. This finding needs to be confirmed in stable ischemic patients, and the PFA100CTCEPI cut-off needs to be refined in these patients.
منابع مشابه
Prevalence rate of aspirin resistance in cardiovascular disease patients: A systematic review and meta-analysis
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