Thromboxane Formation Assay to Identify High On-Treatment Platelet Reactivity to Aspirin

被引:6
|
作者
Mohring, Annemarie [1 ]
Piayda, Kerstin [1 ]
Dannenberg, Lisa [1 ]
Zako, Saif [1 ]
Schneider, Theresa [1 ]
Bartkowski, Kirsten [2 ]
Levkau, Bodo [3 ]
Zeus, Tobias [1 ]
Kelm, Malte [1 ]
Hohlfeld, Thomas [2 ]
Polzin, Amin [1 ]
机构
[1] Heinrich Heine Univ, Med Ctr Dusseldorf, Div Cardiol Pulmonol & Vasc Med, Dusseldorf, Germany
[2] Heinrich Heine Univ, Inst Pharmacol & Clin Pharmacol, Dusseldorf, Germany
[3] Univ Duisburg Essen, Univ Hosp Essen, Inst Pathophysiol, West German Heart & Vasc Ctr, Essen, Germany
关键词
Aspirin; Platelet activation; Platelet inhibition; High on-treatment reactivity; Thromboxane; DIPYRONE METAMIZOLE; CORONARY; INHIBITION;
D O I
10.1159/000477303
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
Platelet inhibition by aspirin is indispensable in the secondary prevention of cardiovascular events. Nevertheless, impaired aspirin antiplatelet effects (high on-treatment platelet reactivity [HTPR]) are frequent. This is associated with an enhanced risk of cardiovascular events. The current gold standard to evaluate platelet hyper-reactivity despite aspirin intake is the light-transmittance aggregometry (LTA). However, pharmacologically, the most specific test is the measurement of arachidonic acid (AA)-induced thromboxane (TX) B2 formation. Currently, the optimal cut-off to define HTPR to aspirin by inhibition of TX formation is not known. Therefore, in this pilot study, we aimed to calculate a TX formation cut-off value to detect HTPR defined by the current gold standard LTA. We measured platelet function in 2,507 samples. AA-induced TX formation by ELISA and AA-induced LTA were used to measure aspirin antiplatelet effects. TX formation correlated nonlinearly with the maximum of aggregation in the AA-induced LTA (Spearman's rho R = 0.7396; 95% CI 0.7208-0.7573, p < 0.0001). Receiver operating characteristic analysis and Youden's J statistics revealed 209.8 ng/mL as the optimal cut-off value to detect HTPR to aspirin with the TX ELISA (area under the curve: 0.92, p < 0.0001, sensitivity of 82.7%, specificity of 90.3%). In summary, TX formation ELISA is reliable in detecting HTPR to aspirin. The calculated cut-off level needs to be tested in trials with clinical end points. (C) 2017 S. Karger AG, Basel
引用
收藏
页码:127 / 130
页数:4
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