ASPIRIN-RESISTANCE IN CHILDREN
Abstract number: P-T-349
Rauch1 R., Wiegand1 G., Stellos2 K., Girisch1 M., Hofbeck1 M., Gawaz2 M.
11Abteilung für Kardiologie, Universitatsklinik für Kinder und Jugendliche 22Abteilung für Kardiologie, Medizinische Klinik III, Tuebingen, Germany
How-to-cite Rauch R, Wiegand G, Stellos K, Girisch M, Hofbeck M, Gawaz M. ASPIRIN-RESISTANCE IN CHILDREN. J Thromb Haemost 2007; 5 Supplement 2: P-T-349
Introduction: Aspirin is the most important drug in the prevention of atherothrombotic disease. However, some patients experience recurrent vascular events despite treatment with Aspirin, they are designated as aspirin-resistent. This term has been used to describe biocemical (persistent platelet activation, demonstrated by platelet function tests) as well as clinical phenomena (the recurrence of vascular events in patients). In adults the frequency of the Aspirin-resistance is indicated with 5,5% to 56%.
The aim of our study was to determine the frequency of Aspirin-resistance in childhood and the dose necessary in order to achieve a biocemical effect.In the case of inadequate effect: can it be produced by an increase of the dose of Aspirin?
Methods: We included children following interventional closure of atrial septal defects or after surgical interventions in functionally univentricular hearts, needing antithrombotic prophylaxis according to general agreement.
Aspirin resistance was investigated by the in-vitro bleeding time (PFA 100), a platelet aggregation test according to a turbidimetric method, a flow-cytometric method (FACS) and the concentration of 11-dehydro-thromboxan B2 in the urine
Results: To date, complete data of 21 patients were obtained:
Aspirin was effective in 18 children in a dose of 3mg/kg/d.
Aspirin was effective in one patient after doubling the dose to 6mg/kg/d.
In two patients no effect could be obtained, even after doubling the dose
Conclusions: The phenomenon of Aspirin-resistance exists in children as well as in adults. Therefore, before setting these patients on a long lasting prophylaxis monitoring of the effect of Aspirin appears to be reasonable. However the gold standard still has to be determined as sample volumes in infants and methodic problems persist.
To cite this abstract use the following format:
Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number
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