Antiplatelet agents in out of hospital cardiac arrest survivors—does an impaired biological response increase stent thrombosis risk?

Llitjos et al. present an interesting and thought provoking paper on impaired response to aspirin in the setting of induced hypothermia after out of hospital cardiac arrest (OHCA). In this study of resuscitated cardiac arrest patients with a requirement for antiplatelet therapy, impaired responses to both intravenous and oral aspirin were observed. Interestingly, this effect was more marked in those receiving aspirin via the oral route (1). This study therefore raises important clinical questions as to the efficacy of antiplatelet agents in this setting, the optimal route of administration and potential clinical sequelae in a unique and complex cohort.