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Oral aspirin or low dose of intravenous lysine acetylsalicylate in ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Ferlini, Marco; Leonardi, Sergio; Mandurino Mirizzi, Alessandro; Montalto, Claudio; Crimi, Gabriele; Repetto, Alessandra; Marinoni, Barbara; Somaschini, Alberto; Ferrario, Maurizio; Klersy, Catherine; Oltrona Visconti, Luigi.
Affiliation
  • Ferlini M; Division of Cardiology.
  • Leonardi S; Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo.
  • Mandurino Mirizzi A; Department of Molecular Medicine, University of Pavia.
  • Montalto C; Division of Cardiology.
  • Crimi G; Division of Cardiology.
  • Repetto A; Department of Molecular Medicine, University of Pavia.
  • Marinoni B; Division of Cardiology.
  • Somaschini A; Division of Cardiology.
  • Ferrario M; Division of Cardiology.
  • Klersy C; Division of Cardiology.
  • Oltrona Visconti L; Department of Molecular Medicine, University of Pavia.
J Cardiovasc Med (Hagerstown) ; 22(7): 539-545, 2021 07 01.
Article in En | MEDLINE | ID: mdl-34076601
AIM: To compare the pharmacodynamic effect of an oral loading dose of 'noncoated' ASA 300 mg vs. an intravenous bolus injection of lysine acetylsalicylate 150 mg in patients with STEMI undergoing pPCI. METHODS: This was a prospective single-center, open label, pharmacodynamic study, including nonconsecutive patients presenting at our catheterization laboratory with STEMI undergoing pPCI and not receiving ASA within the previous 7 days. Pharmacodynamic analyses were performed at five time points: baseline, and 1, 2, 4 and 12 h after the loading dose, and measured as ASA reaction units (ARU) by the Verify Now System. An ARU more than 550 was considered as nonresponsiveness to study drugs. The primary end point was the different rate of patients with ARU more than 550 at 2 h after the loading dose of oral vs. intravenous ASA. Secondary end points included the comparison of ARU more than 550 at the other time points and the comparison of continuous ARU at each time point. RESULTS: The study was planned with a sample size of 68 patients, but it was prematurely stopped due to slow enrollment after the inclusion of 23 patients, 12 randomized to oral ASA and 11 to intravenous lysine acetylsalicylate. At 2 h the rate of patients with ARU more than 550 was numerically but not significantly higher in patients receiving oral ASA as compared with intravenous lysine acetylsalicylate (33 vs. 14.2%; Δ -0.19, 95% confidence interval -0.59-0.21, P = 0.58). The difference over time was NS (P = 0.98), though the prevalence of ARU more than 550 was higher at the other time points. Both routes of administration reduced ARU values over time, though with no overall significant difference between profiles (P overall = 0.48). CONCLUSION: In patients with STEMI undergoing pPCI the rate of nonresponsiveness to ASA was not different comparing an oral 'noncoated' loading dose of ASA with an intravenous bolus injection of lysine acetylsalicylate. However, as patient enrollment was prematurely terminated, this study is underpowered to draw a definite conclusion.
Subject(s)

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Aspirin / Drug Monitoring / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Lysine Type of study: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Language: En Journal: J Cardiovasc Med (Hagerstown) Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2021 Document type: Article Country of publication: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Aspirin / Drug Monitoring / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Lysine Type of study: Clinical_trials / Diagnostic_studies / Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male Language: En Journal: J Cardiovasc Med (Hagerstown) Journal subject: ANGIOLOGIA / CARDIOLOGIA Year: 2021 Document type: Article Country of publication: United States