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Binderup HG, Houlind K, Brasen CL, Madsen JS. Identification of aspirin resistance using a PDW-miR92a-score: Validation in an intermittent claudication cohort. Clin Biochem 2019; 64:30-36. [DOI: 10.1016/j.clinbiochem.2018.12.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 11/23/2018] [Accepted: 12/21/2018] [Indexed: 01/09/2023]
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De Lorenzo A, Dutra M, Mattos MD, Rey H, Tibirica E. Evaluation of platelet activity by multiple electrode impedance aggregometry in acute coronary syndromes: pilot study in a Brazilian tertiary-care public hospital. Braz J Med Biol Res 2019; 52:e8001. [PMID: 30652826 PMCID: PMC6328968 DOI: 10.1590/1414-431x20188001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 11/07/2018] [Indexed: 11/22/2022] Open
Abstract
There is no definite recommendation for testing platelet aggregation (PA) in acute coronary syndromes (ACS) due to inconclusive evidence on the usefulness of platelet function tests to guide therapy and improve clinical outcomes. The evaluation of PA with multiple electrode impedance platelet aggregometry (MEA) may be useful to manage antiplatelet therapy and possibly influence patient outcome. The primary aim of this study was to measure PA with MEA in Brazilian patients with ACS and evaluate the association between PA and adverse clinical outcomes. Forty-seven consecutive patients admitted with ACS to a Brazilian tertiary-care public hospital were studied and PA was evaluated using MEA. Patients were followed for six months for the occurrence of all-cause death, acute myocardial infarction, or stroke. Suboptimal inhibition of PA was found in 7 patients (14.9%); 5 (10.6%) in response to ASA (acetylsalicylic acid), 2 (5.0%) to clopidogrel, and none to ticagrelor. Inadequate PA inhibition in response to ASA was significantly associated with the composite end point, but there was no significant association for insufficient PA inhibition in response to clopidogrel. This study suggested that the evaluation of PA in ACS using MEA may identify non-responders to ASA. Larger studies are necessary to define, in a public health scenario, the value of MEA in the management of ACS.
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Westgarth S, Blois SL, D. Wood R, Verbrugghe A, Ma DW. Effects of omega-3 polyunsaturated fatty acids and aspirin, alone and combined, on canine platelet function. J Small Anim Pract 2017; 59:272-280. [DOI: 10.1111/jsap.12776] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 07/10/2017] [Accepted: 08/03/2017] [Indexed: 11/29/2022]
Affiliation(s)
- S. Westgarth
- Department of Clinical Studies; University of Guelph; Guelph Ontaria N1G 2W1 Canada
| | - S. L. Blois
- Department of Clinical Studies; University of Guelph; Guelph Ontaria N1G 2W1 Canada
| | - R. D. Wood
- Department of Pathobiology; University of Guelph; Guelph Ontaria N1G 2W1 Canada
| | - A. Verbrugghe
- Department of Clinical Studies; University of Guelph; Guelph Ontaria N1G 2W1 Canada
| | - D. W. Ma
- Department of Human Health and Nutritional Sciences; University of Guelph; Guelph Ontaria N1G 2W1 Canada
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Wand S, Adam EH, Wetz AJ, Meybohm P, Kunze-Szikszay N, Zacharowski K, Popov AF, Moritz A, Moldenhauer L, Kaiser J, Bauer M, Weber CF. The Prevalence and Clinical Relevance of ASA Nonresponse After Cardiac Surgery: A Prospective Bicentric Study. Clin Appl Thromb Hemost 2017; 24:179-185. [PMID: 28301911 DOI: 10.1177/1076029617693939] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We aimed to identify the prevalence of acetylsalicylic acid (ASA) nonresponse in patients after coronary artery bypass graft (CABG) surgery and the possible consequences for the rate of major cardiovascular events. This prospective, observational, bicentric cohort study was conducted in two German University hospitals. A total of 400 patients (200 in each study center) undergoing elective CABG surgery were enrolled after written informed consent. Platelet function was analyzed on day 3 (d3) and day 5 (d5) postoperatively following stimulation with arachidonic acid (ASPItest) and with thrombin receptor-activating peptide 6 (TRAPtest) using multiple electrode aggregometry (Multiplate). Individuals with an ASPItest ≥40 AU·min were categorized as ASA nonresponders. A 1-year follow-up recorded the combined end point of cardiovascular events, hospital admissions, or deaths related to cardiovascular disease. The prevalence of ASA nonresponse was 51.5% on d3, and it significantly increased to 71.3% on d5 ( P = .0049). The area under the aggregation curve in the TRAPtest ( P < .0001), the platelet count on d5 ( P = .009), and the cardiopulmonary bypass time ( P = .01) were identified as independent predictors of an ASA nonresponse. A 1-year follow-up recorded 54 events fulfilling criteria for the combined end point with no difference between ASA responders and nonresponders. This study indicates a high incidence of perioperative ASA nonresponse in patients following CABG. No effect on the incidence of cardiovascular events was recorded in the 1-year follow-up. Therefore, a randomized dosage adjustment trial should elucidate whether a tailored ASA treatment after CABG surgery represents a useful concept.
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Affiliation(s)
- Saskia Wand
- 1 Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Elisabeth Hannah Adam
- 2 Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anna Julienne Wetz
- 1 Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Patrick Meybohm
- 2 Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Nils Kunze-Szikszay
- 1 Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Kai Zacharowski
- 2 Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Aron Frederick Popov
- 3 Department of Thoracic and Cardiovascular Surgery, University Medical Center Göttingen, Göttingen, Germany.,4 Department for Cardiothoracic and Vascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Anton Moritz
- 4 Department for Cardiothoracic and Vascular Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Lisa Moldenhauer
- 1 Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
| | - Julia Kaiser
- 2 Department of Anesthesia, Intensive Care Medicine and Pain Therapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Martin Bauer
- 1 Department of Anesthesiology, University Medical Center Göttingen, Göttingen, Germany
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Binderup HG, Houlind K, Madsen JS, Brasen CL. Aspirin resistance may be identified by miR-92a in plasma combined with platelet distribution width. Clin Biochem 2016; 49:1167-1172. [PMID: 27208561 DOI: 10.1016/j.clinbiochem.2016.04.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 04/15/2016] [Accepted: 04/16/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Aspirin is a widely used drug for prevention of thrombotic events in cardiovascular patients, but approximately 25% of patients experience insufficient platelet inhibition due to aspirin, and remain in risk of cardiovascular events. This study aimed to investigate the value of circulating miR-92a and platelet size as biomarkers of the individual response to aspirin therapy. METHODS Blood samples were collected from 50 healthy blood donors without antithrombotic medication and 50 patients with intermittent claudication on daily aspirin therapy. Based on results from the arachidonic acid stimulated aggregation test on Multiplate®analyzer (ASPItest), patients were defined as aspirin resistant (n=10) or aspirin responders (n=40). Plasma levels of miR-92a were evaluated by RT-qPCR analysis and platelet distribution width (PDW) was used to assess platelet size variability. Receiver operating characteristic curves for miR-92a levels and PDW were used to set cut-off values for discrimination between aspirin responding and aspirin resistant patients. RESULTS When defining aspirin resistance as an ASPItest ≥30U, the optimal cut-off values for discrimination of aspirin responders and aspirin resistant patients were found to be PDW>11.8fL and a relative expression level of miR-92a>4.5. Using these cut-off values we could define a PDW/miR-92a-score with a specificity of 97.5% and a sensitivity of 80.0% in relation to detect aspirin resistance. The corresponding positive and negative predictive values were found to be 88.9% and 95.1%, respectively. CONCLUSION Aspirin resistance can potentially be identified by miR-92a levels in plasma combined with PDW.
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Affiliation(s)
- Helle Glud Binderup
- Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Kabbeltoft 25, 7100 Vejle and Skovvangen 2-8, 6000 Kolding, Denmark.
| | - Kim Houlind
- Department of Vascular Surgery, Lillebaelt Hospital, Skovvangen 2-8, 6000 Kolding, Denmark; Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Jonna Skov Madsen
- Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Kabbeltoft 25, 7100 Vejle and Skovvangen 2-8, 6000 Kolding, Denmark; Institute of Regional Health Research, University of Southern Denmark, Denmark
| | - Claus Lohman Brasen
- Department of Clinical Immunology and Biochemistry, Lillebaelt Hospital, Kabbeltoft 25, 7100 Vejle and Skovvangen 2-8, 6000 Kolding, Denmark
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