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Objective To determine if there is a relation between aspirin “resistance” and clinical outcomes in patients with cardiovascular disease.

Design Systematic review and meta-analysis.

Data source Electronic literature search without language restrictions of four databases and hand search of bibliographies for other relevant articles.

Review methods Inclusion criteria included a test for platelet responsiveness and clinical outcomes. Aspirin resistance was assessed, using a variety of platelet function assays.

Results 20 studies totalling 2930 patients with cardiovascular disease were identified. Most studies used aspirin regimens, ranging from 75-325 mg daily, and six studies included adjunct antiplatelet therapy. Compliance was confirmed directly in 14 studies and by telephone or interviews in three. Information was insufficient to assess compliance in three studies. Overall, 810 patients (28%) were classified as aspirin …