Analysis of Platelet Function Testing in Children Receiving Aspirin for Antiplatelet Effects

• Published in: Pediatric cardiology 2024-03, Vol.45 (3), p.614-622
• Main Authors: Newland, David M., Palmer, Michelle M., Knorr, Lisa R., Pak, Jennifer L., Albers, Erin L., Friedland-Little, Joshua M., Hong, Borah J., Law, Yuk M., Spencer, Kathryn L., Kemna, Mariska S.
• Format: Article
• Language: English
• Subjects: Cardiac Surgery; Cardiology; Medicine; Medicine & Public Health; Vascular Surgery
• ISSN: 0172-0643; 1432-1971
• DOI: 10.1007/s00246-023-03377-6

Aspirin (ASA) remains the most common antiplatelet agent used in children. VerifyNow Aspirin Test® (VN) assesses platelet response to ASA, with therapeutic effect defined by the manufacturer as ≤ 549 aspirin reaction units (ARU). Single-center, observational, analysis of 195 children ( 549 ARU). Secondary outcomes included incidence of new clinical thrombotic and bleeding events during ≤ 6 months from VN in those who received ASA monotherapy ( n  = 113). Median age was 1.8 years. Common indications for ASA included cardiac anomalies or dysfunction (74.8%) and ischemic stroke (22.6%). Median ASA dose before VN was 4.6 mg/kg/day. Mean VN was 471 ARU. ASA biochemical resistance was detected in 14.4% ( n  = 28). Of 113 patients receiving ASA monotherapy, 14 (12.4%) had a thrombotic event and 2 (1.8%) had a bleeding event. Mean VN was significantly higher at initial testing in patients experiencing thrombotic event compared to those without thrombosis (516 vs 465 ARU, [95% CI: 9.8, 92.2], p  = 0.02). Multivariable analysis identified initial VN ASA result ≥ 500 ARU at initial testing as the only significant independent risk factor for thrombosis ( p