Increased bodyweight and inadequate response to aspirin in individuals with coronary artery disease

Furtado, Remo H M; Giugliano, Robert P.; Dalçóquio, Talia Falcão; Arantes, Flávia Bittar Britto; Barbosa, Camila de Souza; Genestreti, Paulo; Franci, André; Menezes, Fernando; Nakashima, Carlos Alberto Kenji; Filho, Marco Antonio Scanavini; Ferrari, Aline; Salsoso, Rocío; Baracioli, Luciano Moreira; Nicolau, José Carlos

doi:10.1007/s11239-019-01830-z

Cited by 8 publications

(10 citation statements)

References 25 publications

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“…Some studies used laboratory examination such as serum thromboxane B2, arachidonic acid-induced platelet reactivity or VerifyNow aspirin to explore the relationship between body weight and the antiplatelet effect of aspirin. [12][13][14] The results suggest increased body weight is independently associated with impaired response to low-dose aspirin. However, the relationship was not observed in patients who took 300-325 mg of aspirin.…”

Section: Discussionmentioning

confidence: 87%

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Wang

Zhu

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objectives Bleeding is the most common adverse reaction to aspirin and can lead to drug discontinuation or even be life‐threatening in the secondary prevention of stroke or transient ischemic attack. The aim of this study was to evaluate risk factors for bleeding adverse reaction of aspirin in ischemic stroke or transient ischemic attack. Methods This retrospective analysis included patients treated with aspirin (100 mg) as a secondary prevention for ischemic stroke or transient ischemic attack. The bleeding events that occurred during the first year were collected, including gastrointestinal, skin, nasal cavity, gum, and urinary tract bleeding events. Then, univariate and multivariate logistic regression analyses were used to identify independent factors associated with bleeding events of aspirin. Results and discussion A total of 578 patients were enrolled in this study, and 58 patients developed bleeding during the first year of secondary prevention. Body weight and combination with selective serotonin reuptake inhibitors were found to be significant risk factors for overall bleeding (p = 0.025 and 0.012). Body weight below 60 kg was a risk factor for overall bleeding and gastrointestinal bleeding events. What is new and conclusion Patients weighing less than 60 kg were at increased risk of bleeding with 100 mg aspirin for secondary prevention of cerebral infarction transient ischemic attack.

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Section: Discussionmentioning

confidence: 87%

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Wang

Zhu

et al. 2022

Clinical Pharmacy Therapeu

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“…Our main finding was that high Lp(a) concentration, defined as Lp(a) C 50 mg/dL [23][24][25][26]34], is unrelated to platelet reactivity as assessed by multiple established tests [31][32][33][34][35][36], and regardless of the presence or absence of CAD. To the best of our knowledge, the present study is the first to analyze the potential association between high concentrations of Lp(a) and platelet reactivity in individuals with and without CAD, which could contribute to a better understanding of the pathophysiology of atherosclerosis [2][3][4][5].…”

Section: Discussionmentioning

confidence: 99%

“… Thromboxane B 2 (TxB 2 ). TxB 2 (pg/mL) was measured in serum samples using a commercial ELISA kit (Millipore Sigma; Burlington, MA, USA), as previously described [ 32 ]. Briefly, PRP treated with 10 μmol/L ADP was quenched for 5 min with 5 mmol/L ethylenediaminetetraacetic acid and 200 μmol/L indomethacin.…”

Section: Methodsmentioning

confidence: 99%

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

et al. 2020

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Introduction Lipoprotein ( a ) [Lp( a )] is a risk factor for coronary artery disease (CAD). To the best of our knowledge, this is the first study addressing the relationship between Lp( a ) and platelet reactivity in primary and secondary prevention. Methods Lp( a ) was evaluated in 396 individuals with (82.3%) and without (17.7%) obstructive CAD. The population was divided into two groups according to Lp( a ) concentrations with a cutoff value of 50 mg/dL. The primary objective was to evaluate the association between Lp( a ) and adenosine diphosphate (ADP)-induced platelet reactivity using the VerifyNow™ P2Y 12 assay. Platelet reactivity was also induced by arachidonic acid and collagen–epinephrine (C-EPI) and assessed by Multiplate™, platelet function analyzer™ 100 (PFA-100), and light transmission aggregometry (LTA) assays. Secondary objectives included the assessment of the primary endpoint in individuals with or without CAD. Results Overall, 294 (74.2%) individuals had Lp( a ) < 50 mg/dL [median (IQR) 13.2 (5.8–27.9) mg/dL] and 102 (25.8%) had Lp( a ) ≥ 50 mg/dL [82.5 (67.6–114.5) mg/dL], P < 0.001. Univariate analysis in the entire population revealed no differences in ADP-induced platelet reactivity between individuals with Lp( a ) ≥ 50 mg/dL (249.4 ± 43.8 PRU) versus Lp( a ) < 50 mg/dL (243.1 ± 52.2 PRU), P = 0.277. Similar findings were present in individuals with ( P = 0.228) and without ( P = 0.669) CAD, and regardless of the agonist used or method of analysis (all P > 0.05). Finally, multivariable analysis did not show a significant association between ADP-induced platelet reactivity and Lp( a ) ≥ 50 mg/dL [adjusted OR = 1.00 [(95% CI 0.99–1.01), P = 0.590]. Conclusion In individuals with or without CAD, Lp( a ) ≥ 50 mg/dL was not associated with higher platelet reactivity. Electronic supplementary material The online version of this article (10.1007/s12325-020-01483-y) contains supplementary material, which is available to authorized users.

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“…This effect is termed "hypo-response," also known as "high on-treatment platelet reactivity" or "resistance." [4][5][6][7][8][9][10][11] Besides, DAPT increases the risk of life-threatening hemorrhagic complications. 12) Therefore, we need to manage DAPT in the optimum range to prevent not only thromboembolic but also hemorrhagic complications.…”

Section: Introductionmentioning

confidence: 99%

“…The VerifyNow (Accumetrics, Inc., San Diego, CA, USA) assay analyses platelet functions quickly and easily. 4) Many studies using VerifyNow have provided useful evidence about hypo-response to aspirin or clopidogrel, [4][5][6][7][8][9][10][11][13][14][15][16][17] as well as hyper-response to clopidogrel. 4,13,18) Recently, dynamic variability in response to clopidogrel after endovascular treatment has been reported 10,[18][19][20][21][22][23] ; however, individual changes in platelet functions in the short period under DAPT have not been described yet.…”

Section: Introductionmentioning

confidence: 99%

Periprocedural Variability of Platelet Functions in Carotid Artery Stenting: An Analysis Using VerifyNow

Yoshimura

Sumita

Fujii

et al. 2021

NOUSHINKEI KEKKANNAI TIRYOU

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The assessment of platelet functions is necessary to prevent both thromboembolic and hemorrhagic complications under dual antiplatelet therapy (DAPT). Using the VerifyNow (Accumetrics, Inc., San Diego, CA, USA) assay, this study aimed to reveal time-dependent changes in platelet functions after carotid artery stenting (CAS). Methods:We enrolled retrospectively 43 patients who underwent CAS under DAPT. Aspirin reaction unit (ARU) and P2Y12 reaction unit (PRU) values were determined on the day before and on days 1, 3, and 7 after the procedure.Multiple comparison tests (MCTs) were performed among ARU and PRU measurement points, and the proportions of hypo-and hyper-responses were compared. Results:The median ARU values were 408 (interquartile range: 392-497) before CAS and 418 (405-470) on day 1, 405 (393.0-460.5) on day 3, and 402 (388.5-477.5) on day 7 (not significant in MCTs). The percentages of hypo-responses were 16.3%, 7.0%, 2.3%, and 7.0%, respectively (p = 0.11). The significantly different median PRU values were 173 (116.5-209.5), 233 (166.5-273.5), 139 (70.5-205.5), and 51 (9.0-79.5), respectively. The median PRU was before the procedure within the therapeutic range but exceeded the upper cutoff on day 1 and was below the lower cutoff on day 7.The percentages of hypo-responses were 14.0%, 51.2%, 18.6%, and 11.6%, respectively (p <0.001) and the percentages of hyper-responses were 9.3%, 2.3%, 23.3%, and 62.8%, respectively (p <0.001). Conclusion:In the periprocedural CAS period, ARU values were stable, but PRU values showed time-dependent changes. PRU values were above the therapeutic range the day after CAS but decreased below this range on day 7.

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Increased bodyweight and inadequate response to aspirin in individuals with coronary artery disease

Cited by 8 publications

References 25 publications

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Effect of body weight on bleeding events of aspirin in ischemic stroke or transient ischemic attack patients

Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

Periprocedural Variability of Platelet Functions in Carotid Artery Stenting: An Analysis Using VerifyNow

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