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
机构:
Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Ludwig Boltzmann Cluster Cardiovasc Res, Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Freynhofer, Matthias K.
Bruno, Veronika
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Wilhelminen Hosp, Dept Obstet & Gynecol, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Bruno, Veronika
Brozovic, Ivan
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Brozovic, Ivan
Jarai, Rudolf
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Jarai, Rudolf
Vogel, Birgit
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Vogel, Birgit
Farhan, Serdar
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Farhan, Serdar
Huebl, Wolfgang
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Wilhelminen Hosp, Dept Lab Med, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Huebl, Wolfgang
Willheim, Martin
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Wilhelminen Hosp, Dept Lab Med, A-1160 Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Willheim, Martin
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Wojta, Johann
Huber, Kurt
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Wilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
Ludwig Boltzmann Cluster Cardiovasc Res, Vienna, AustriaWilhelminen Hosp, Dept Med 3, A-1160 Vienna, Austria
机构:
Haaglanden Med Ctr, The Hague, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
Goncalves, Lauren N.
van Velze, Veerle
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Haaglanden Med Ctr, The Hague, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
van Velze, Veerle
Klok, Frederikus A.
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LUMC, Clin Pharmacol & Toxicol, Leiden, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
Klok, Frederikus A.
Gal, Pim
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Ctr Human Drug Res, Leiden, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
Gal, Pim
Vos, Rimke C.
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LUMC, Clin Pharmacol & Toxicol, Leiden, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
Vos, Rimke C.
Hamming, Jaap F.
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LUMC, Clin Pharmacol & Toxicol, Leiden, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
Hamming, Jaap F.
van der Bogt, Koen E. A.
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Haaglanden Med Ctr, The Hague, Netherlands
Haaglanden Med Ctr, Lijnbaan 32, NL-2512 VA The Hague, NetherlandsHaaglanden Med Ctr, The Hague, Netherlands
机构:
St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
St Antonius Ctr Platelet Funct Res, Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
Breet, Nicoline J.
van Werkum, Jochem W.
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St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
St Antonius Ctr Platelet Funct Res, Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
van Werkum, Jochem W.
Bouman, Heleen J.
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h-index: 0
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St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
St Antonius Ctr Platelet Funct Res, Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
Bouman, Heleen J.
Kelder, Johannes C.
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h-index: 0
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St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
St Antonius Ctr Platelet Funct Res, Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
Kelder, Johannes C.
Harmsze, Ankie M.
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h-index: 0
机构:
St Antonius Hosp, Dept Clin Pharm, NL-3435 CM Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
Harmsze, Ankie M.
Hackeng, Christian M.
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h-index: 0
机构:
St Antonius Ctr Platelet Funct Res, Nieuwegein, Netherlands
St Antonius Hosp, Dept Clin Chem, NL-3435 CM Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
Hackeng, Christian M.
ten Berg, Jurrien M.
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St Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
St Antonius Ctr Platelet Funct Res, Nieuwegein, NetherlandsSt Antonius Hosp, Dept Cardiol, NL-3435 CM Nieuwegein, Netherlands
机构:
Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Chen, Haoxuan
Zhan, Yibo
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Zhan, Yibo
Lou, Zhenzhen
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Lou, Zhenzhen
Mao, Hui
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Mao, Hui
Zhang, Changlin
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Zhang, Changlin
Li, Xiaojun
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Li, Xiaojun
Chen, Guixian
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Chen, Guixian
Ouyang, Huiying
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Guangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Ouyang, Huiying
Huang, Zhiping
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Huang, Zhiping
Wen, Longlong
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Wen, Longlong
Xu, Haoyou
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Xu, Haoyou
Zheng, Zequan
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Zheng, Zequan
Zhao, Yuanqi
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Zhao, Yuanqi
Zhao, Min
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Guangzhou Univ Chinese Med, Guangdong Prov Hosp Chinese Med, Affiliated Hosp 2, Guangzhou 510120, Peoples R ChinaGuangzhou Univ Tradit Chinese Med, Second Sch Clin Med Sci, Guangzhou 510006, Peoples R China
Zhao, Min
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