Incidence of Aspirin Resistance and Its Relationship With Cardiovascular Risk Factors and Graft Function in Renal Transplant Recipients

Açıkel, Sadık; Yildirir, Aylin; Aydinalp, A.; Demirtaş, Koray; Bal, Uğur Abbas; Kaynar, Gamze; Özin, Bülent; Karakayalı, H.; Müderrisoğlu, Haldun; Haberal, Mehmet

doi:10.1016/j.transproceed.2008.06.108

Cited by 7 publications

(5 citation statements)

References 17 publications

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“…Coll documented in the present paper is independently associated with the risk of a collagen-mediated residual platelet reactivity, despite of ASA treatment. These results are in keeping with a recent observation of "aspirin resistance" documented in 40 RTRs patients with a percentage (27.5%) similar to our finding (33%) (11). The number of newly produced circulating platelets depends on the stimulation of the thrombopoietic capacity of bone marrow as well as on the platelet removal from the bloodstream through an activation-dependent mechanism that enhances platelet turnover.…”

Section: Controls N=60supporting

confidence: 93%

“…To date, epidemiological studies demonstrated that low-dose ASA therapy can substantially improve renal allograft function and survival so reducing the incidence of cardiovascular complications in RTRs patients (10). Nevertheless, it has been recently reported that the magnitude of antiplatelet effects may be depressed in RTRs patients by the presence of an "aspirin resistance" measured by a point-of-care method (11). The presence of an enhanced platelet turnover, as documented by high levels of reticulated platelets (RP) expressed as immature platelet fraction (IPF), was initially reported in populations of patients with idiopathic thrombocytopenic purpura (ITP) (12)(13).…”

Section: Introductionmentioning

confidence: 99%

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High platelet turnover and reactivity in renal transplant recipients patients

Cesari¹,

Marcucci²,

Gori³

et al. 2010

Thromb Haemost

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Renal transplant recipients (RTRs) patients are at increased risk of cardiovascular morbidity and mortality. We aimed this study to assess reticulated platelets (RP), platelet reactivity and von Willebrand factor (vWF) levels in RTRs patients. In 150 RTRs patients [84 (56%) not on acetylsalicylic acid (ASA) treatment, group A; 66 (44%) on ASA 100 mg treatment, group B] and in 60 healthy control subjects, RP were measured by a Sysmex XE-2100 and were expressed as the percentage of RP of the total optical platelet count (immature platelet fraction; IPF), as the percentage of RP highly fluorescent (H-IPF) and as the absolute number of RP (IPF#). Platelet function was assessed by optical aggregometry (PA) induced by 1 mmol arachidonic acid (AA-PA), 2 and 10 μM ADP (ADP2-PA and ADP10-PA) and 2 μg/ml collagen (Coll-PA). vWF levels were measured by using a miniVidas analyser. Group A and group B showed significant higher values of RP than controls. At a multiple linear regression analysis IPF and IPF# were significantly and positively related to collagen-PA. By analysing group B according to residual platelet reactivity (RPR), we observed a significant higher number of RP among patients with RPR by collagen. Moreover at a multiple logistic regression analysis, IPF# significantly affected the risk of having a RPR by collagen. With regard to vWF, RTRs patients showed higher levels than control subjects. We documented a higher platelet turn-over in both groups of RTRs patients and increased platelet reactivity in RTRs patients not on ASA therapy than controls.

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Section: Controls N=60supporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

High platelet turnover and reactivity in renal transplant recipients patients

Cesari¹,

Marcucci²,

Gori³

et al. 2010

Thromb Haemost

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“…Indeed, a recent Swedish study reported the underuse of cardioprotective therapies in patients with CKD [45]. As the prevalence of aspirin resistance is increased in CKD, more attention to this apparently under‐recognized phenomenon in renal patients is also needed [46].…”

Section: Bidirectional Association Between Chronic Kidney and Vasculamentioning

confidence: 99%

Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease

Stenvinkel

2010

Journal of Internal Medicine

300

247

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. Stenvinkel P (Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden). Chronic kidney disease: a public health priority and harbinger of premature cardiovascular disease (Review). J Intern Med 2010; 268: 456–467. The epidemics of cardiovascular disease, obesity, diabetes, HIV and cancer have all received much attention from the public, media and policymakers. By contrast, chronic kidney disease (CKD) has remained largely a ‘silent’ epidemic. This is unfortunate because early diagnosis of renal disease based on proteinuria and/or reduced estimated glomerular filtration rate could enable early intervention to reduce the high risks of cardiovascular events, end‐stage renal disease (ESRD) and death that are associated with CKD. Given the global increase in the incidence of the leading causes of CKD – hypertension, obesity and diabetes mellitus – better disease management and prevention planning are needed, as effective strategies are available to slow the progression of CKD and reduce cardiovascular risk. CKD may be regarded as a clinical model of accelerated vascular disease and premature ageing, and the risk‐factor profile changes during the progression from mild/moderate CKD to ESRD. Although many randomized controlled trials in patients with mild to moderate CKD have shown beneficial effects of interventions aimed at preventing the progression of CKD, most trials have been unable to demonstrate a beneficial effect of interventions aimed at improving outcome in ESRD. Thus, novel treatment strategies are needed in this high‐risk patient group.

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“…Chen et al [3,4] had previously described an association between renal impairment and aspirin resistance. Acikel et al [8] found a 27.5% incidence of aspirin resistance in renal transplant recipients.…”

mentioning

confidence: 99%