{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:14:14Z","timestamp":1793830454022,"version":"4.6.1"},"reference-count":25,"publisher":"FapUNIFESP (SciELO)","issue":"6","license":[{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2020,6,1]],"date-time":"2020-06-01T00:00:00Z","timestamp":1590969600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Assoc. Med. Bras."],"abstract":"<jats:p>SUMMARY In patients with atrial fibrillation, standard anticoagulation with a vitamin K antagonist plus dual antiplatelet therapy with a P2Y12 inhibitor and aspirin is the standard of care after percutaneous coronary intervention (PCI). While this therapy reduces the risk of thrombosis and stroke, it increases the risk of bleeding. It is unclear whether the antiplatelet effect of aspirin and clopidogrel may worsen atrial fibrillation (AF).  OBJECTIVE Thus we aimed to analyze platelet aspirin resistance (AR) and clopidogrel resistance (CR) in acute coronary (ACS) patients based on sinus rhythm (SR) and AF.  METHODS In this prospective trial, we included 543 patients (mean age: 62\u00b1 12 years; range: 26 - 89 years) who were on aspirin and clopidogrel therapy after the diagnosis of acute coronary syndrome. AR and CR were analyzed by a Multiplate\u00ae MP-0120 device by using the method of whole blood aggregometry.  RESULTS AF patients had significantly higher age, mean platelet volume, and High-Sensitivity C-Reactive Protein (p&lt; 0.01 for each parameter). Similarly, Arachidonic-acid induced (ASPI) aggregation was higher in AF patients compared to SR patients (666\u00b1218 vs. 187\u00b1179, p&lt;0.001). Among the ACS patients, significantly more female patients had AF (p&lt;0.001). The incidence of hypertension in the AF group was higher compared to the SR group (p&lt;0.001). However, adenosine diphosphate levels were not at a significant level in the two groups.  CONCLUSION Our findings indicate that the platelet inhibitory effect of Aspirin was worse for patients with AF, suggesting that the effectiveness of aspirin may be less in the prophylaxis of thromboembolism and more a bleeding risk.<\/jats:p>","DOI":"10.1590\/1806-9282.66.6.800","type":"journal-article","created":{"date-parts":[[2020,7,20]],"date-time":"2020-07-20T12:14:46Z","timestamp":1595247286000},"page":"800-805","source":"Crossref","is-referenced-by-count":3,"title":["Incidence of aspirin resistance is higher in patients with acute coronary syndrome and atrial fibrillation than without atrial fibrillation"],"prefix":"10.1590","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7110-3443","authenticated-orcid":false,"given":"Hasan Aydin","family":"Ba\u015f","sequence":"first","affiliation":[{"name":"Isparta City Hospital,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6480-4935","authenticated-orcid":false,"given":"Fatih","family":"Aksoy","sequence":"additional","affiliation":[{"name":"Suleyman Demirel University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8792-6329","authenticated-orcid":false,"given":"Ali","family":"Ba\u011fc\u0131","sequence":"additional","affiliation":[{"name":"Suleyman Demirel University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3460-6011","authenticated-orcid":false,"given":"Ercan","family":"Varol","sequence":"additional","affiliation":[{"name":"Suleyman Demirel University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1813-9305","authenticated-orcid":false,"given":"Ahmet","family":"Alt\u0131nba\u015f","sequence":"additional","affiliation":[{"name":"Suleyman Demirel University,  Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2020,6]]},"reference":[{"issue":"2","key":"ref1","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1016\/j.ahj.2007.09.003","article-title":"Discharge antithrombotic strategies among patients with acute coronary syndrome previously on warfarin anticoagulation: physician practice in the CRUSADE registry","volume":"155","author":"Wang TY","year":"2008","journal-title":"Am Heart J"},{"issue":"3","key":"ref2","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/MCA.0b013e328012a964","article-title":"Periprocedural and medium-term antithrombotic strategies in patients with an indication for long-term anticoagulation undergoing coronary angiography and intervention","volume":"18","author":"Rubboli A","year":"2007","journal-title":"Coronary Artery Dis"},{"issue":"45","key":"ref3","doi-asserted-by":"crossref","first-page":"3155","DOI":"10.1093\/eurheartj\/ehu298","article-title":"Management of antithrombotic therapy in atrial fibrillation patients presenting with acute coronary syndrome and\/or undergoing percutaneous coronary or valve interventions: a joint consensus document of the European Society of Cardiology Working Group on Thrombosis, European Heart Rhythm Association (EHRA), European Association of Percutaneous Cardiovascular Interventions (EAPCI) and European Association of Acute Cardiac Care (ACCA) endorsed by the Heart Rhythm Society (HRS) and Asia-Pacific Heart Rhythm Society (APHRS)","volume":"35","author":"Lip GY","year":"2014","journal-title":"Eur Heart J"},{"issue":"10","key":"ref4","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.jacc.2015.10.005","article-title":"2015 ACC\/AHA\/SCAI focused update on primary percutaneous coronary intervention for patients with ST-elevation myocardial infarction: an update of the 2011 ACCF\/AHA\/SCAI guideline for percutaneous coronary intervention and the 2013 ACCF\/AHA guideline for the management of ST-elevation myocardial infarction","volume":"67","author":"Levine GN","year":"2016","journal-title":"J Am Coll Cardiol"},{"issue":"4","key":"ref5","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1093\/ejcts\/ezu366","article-title":"2014 ESC\/EACTS Guidelines on myocardial revascularization: the Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)","volume":"46","author":"Kolh P","year":"2014","journal-title":"Eur J Cardio-Thoracic Surg"},{"issue":"18","key":"ref6","doi-asserted-by":"crossref","first-page":"2067","DOI":"10.1161\/CIRCULATIONAHA.109.924944","article-title":"Triple antithrombotic therapy in patients with atrial fibrillation and coronary artery stents","volume":"121","author":"Paikin JS","year":"2010","journal-title":"Circulation"},{"issue":"9872","key":"ref7","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/S0140-6736(12)62177-1","article-title":"WOEST study investigators. Use of clopidogrel with or without aspirin in patients taking oral anticoagulant therapy and undergoing percutaneous coronary intervention: an open-label, randomised, controlled trial","volume":"381","author":"Dewilde WJ","year":"2013","journal-title":"Lancet"},{"issue":"16","key":"ref8","doi-asserted-by":"crossref","first-page":"1619","DOI":"10.1016\/j.jacc.2015.02.050","article-title":"Duration of triple therapy in patients requiring oral anticoagulation after drug-eluting stent implantation: the ISAR-TRIPLE trial","volume":"65","author":"Fiedler KA","year":"2015","journal-title":"J Am Coll Cardiol"},{"issue":"16","key":"ref9","doi-asserted-by":"crossref","first-page":"1513","DOI":"10.1056\/NEJMoa1708454","article-title":"Dual antithrombotic therapy with dabigatran after PCI in atrial fibrillation","volume":"377","author":"Cannon CP","year":"2017","journal-title":"N Engl J Med"},{"issue":"25","key":"ref10","doi-asserted-by":"crossref","DOI":"10.1056\/NEJMoa1611594","article-title":"Prevention of bleeding in patients with atrial fibrillation undergoing PCI","volume":"375","author":"Gibson CM","year":"2016","journal-title":"N Engl J Med"},{"issue":"16","key":"ref11","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJMoa1817083","article-title":"Antithrombotic therapy after acute coronary syndrome or PCI in atrial fibrillation","volume":"380","author":"Lopes RD","year":"2019","journal-title":"N Engl J Med"},{"issue":"38","key":"ref12","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1093\/eurheartj\/ehw210","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"37","author":"Kirchhof P","year":"2016","journal-title":"Eur Heart J"},{"issue":"06","key":"ref13","first-page":"781","article-title":"Multiple electrode aggregometry: a new device to measure platelet aggregation in whole blood","volume":"95","author":"T\u00f3th O","year":"2006","journal-title":"Thromb Haemost"},{"issue":"10","key":"ref14","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/j.jacc.2008.11.030","article-title":"Platelet reactivity after clopidogrel treatment assessed with point-of-care analysis and early drug-eluting stent thrombosis","volume":"53","author":"Sibbing D","year":"2009","journal-title":"J Am Coll Cardiol"},{"issue":"1","key":"ref15","doi-asserted-by":"crossref","DOI":"10.1186\/s12883-016-0778-x","article-title":"Assessment of platelet function in patients with stroke using multiple electrode platelet aggregometry: a prospective observational study","volume":"16","author":"Sabra A","year":"2016","journal-title":"BMC Neurol"},{"issue":"5","key":"ref16","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1161\/CIRCINTERVENTIONS.111.965186","article-title":"Antithrombotic therapy in patients with atrial fibrillation undergoing coronary stenting: a North American perspective: executive summary","volume":"4","author":"Faxon DP","year":"2011","journal-title":"Circ Cardiovasc Interv"},{"issue":"7","key":"ref17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0132629","article-title":"The influence of haemoglobin A1c levels on platelet aggregation and platelet turnover in patients with coronary artery disease treated with aspirin","volume":"10","author":"Neergaard-Petersen S","year":"2015","journal-title":"PloS One"},{"issue":"3","key":"ref18","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1590\/1516-3180.2018.0431140319","article-title":"The CHA2DS2-VASc score for predicting atrial fibrillation in patients presenting with ST elevation myocardial infarction: prospective observational study","volume":"137","author":"Aksoy F","year":"2019","journal-title":"Sao Paulo Med J"},{"issue":"8","key":"ref19","doi-asserted-by":"crossref","first-page":"243","DOI":"10.4330\/wjc.v2.i8.243","article-title":"Atrial fibrillation and inflammation","volume":"2","author":"Ozaydin M","year":"2010","journal-title":"World J Cardiol"},{"issue":"3","key":"ref20","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1253\/circj.CJ-15-0138","article-title":"Role of inflammation in atrial fibrillation pathophysiology and management","volume":"79","author":"Harada M","year":"2015","journal-title":"Circ J"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"2326","DOI":"10.1016\/j.jacc.2004.03.023","article-title":"Soluble CD40 ligand and platelets: self-perpetuating pathogenic loop in thrombosis and inflammation?","volume":"43","author":"Aukrust P","year":"2004","journal-title":"J Am Coll Cardiol"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.ijcard.2015.04.152","article-title":"Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction: a systematic review and meta-analysis","volume":"190","author":"Ren Y","year":"2015","journal-title":"Int J Cardiol"},{"issue":"24","key":"ref23","doi-asserted-by":"crossref","first-page":"2886","DOI":"10.1161\/hc4901.101760","article-title":"C-reactive protein elevation in patients with atrial arrhythmias: inflammatory mechanisms and persistence of atrial fibrillation","volume":"104","author":"Chung MK","year":"2001","journal-title":"Circulation"},{"issue":"2","key":"ref24","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.ijcard.2006.09.015","article-title":"Inflammatory markers according to types of atrial fibrillation","volume":"120","author":"Gedikli O","year":"2007","journal-title":"Int J Cardiol"},{"issue":"8","key":"ref25","doi-asserted-by":"crossref","first-page":"973","DOI":"10.3109\/07420528.2013.790045","article-title":"Relationships of different blood pressure categories to indices of inflammation and platelet activity in sustained hypertensive patients with uncontrolled office blood pressure","volume":"30","author":"Erdogan D","year":"2013","journal-title":"Chronobiol Int"}],"container-title":["Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira"],"original-title":[],"link":[{"URL":"http:\/\/www.scielo.br\/pdf\/ramb\/v66n6\/1806-9282-ramb-66-6-0800.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,23]],"date-time":"2021-01-23T22:50:23Z","timestamp":1611442223000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0104-42302020000600800&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":25,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["S0104-42302020000600800"],"URL":"https:\/\/doi.org\/10.1590\/1806-9282.66.6.800","relation":{},"ISSN":["1806-9282","0104-4230"],"issn-type":[{"value":"1806-9282","type":"electronic"},{"value":"0104-4230","type":"print"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}