• Jean-François Llitjos, Georgios Sideris, Sebastian Voicu, Claire Bal Dit Sollier, Nicolas Deye, Bruno Megarbane, Ludovic Drouet, Patrick Henry, and Jean-Guillaume Dillinger.
• Department of Cardiology - Inserm U942, Lariboisiere Hospital, AP-HP, Paris Diderot University, Sorbonne Paris Cité, Paris, France.
• Resuscitation. 2016 Aug 1; 105: 16-21.

Aim Of The StudyAcute coronary syndrome is one of the main causes of out-of-hospital cardiac arrest (OHCA). OHCA patients are particularly exposed to high platelet reactivity (HPR) under aspirin (ASA) treatment. The aim was to evaluate HPR-ASA in therapeutic hypothermia comatose patients resuscitated from OHCA.Methods And ResultsTwenty-two consecutive patients with OHCA of cardiac origin were prospectively included after therapeutic hypothermia and randomized to receive ASA 100mg per day, either intravenously (n=13) or orally via a gastric tube (n=9). ADP inhibitors (prasugrel or, if contra-indicated, clopidogrel) were administered in the event of angioplasty. HPR-ASA was assessed by light transmission aggregometry (LTA) with arachidonic acid (AA) and by the PFA-100(®) system with collagen/epinephrine. Clinical, biological and angiographic characteristics were similar in both groups. Using LTA-AA, maximum aggregation intensity was significantly lower in the intravenous group compared to the oral group (15% vs. 29%, respectively; p=0.04). Overall, 10 patients (45%) had HPR-ASA (38% intravenously vs 56% orally; p=0.7). Similarly, closure time was significantly increased in the IV group (277s vs. 155s, respectively; p=0.04).ConclusionThis study suggests that impaired response to both intravenous and oral aspirin is frequent in comatose patients resuscitated from OHCA.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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