Prevalence of high on-treatment platelet reactivity in patients with chronic kidney disease treated with acetylsalicylic acid for stroke prevention

Horyniecki, Maciej; Łącka-Gaździk, Beata; Niewiadomska, Ewa; Mazur, Bogdan; Śnit, Mirosław; Łabuz-Roszak, Beata

doi:10.20452/pamw.4349

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…The most potent discriminator of the response to aspirin was age, as those older than 49 years of age, especially female patients, displayed the lowest platelet aggregation values. This might explain why females, especially older ones, under treatment with aspirin might be at increased bleeding risk, as reported in several studies . In opposite, younger males had less potent aspirin effect on average, which, however, was sufficient in the majority of them with only 12% HTPR.…”

Section: Discussionmentioning

confidence: 76%

“…This might explain why females, especially older ones, under treatment with aspirin might be at increased bleeding risk, as reported in several studies. 33,34 In opposite, younger males had less potent aspirin effect on average, which, however, was sufficient in the majority of them with only 12% HTPR. For ADP antagonists, we identified platelet count (>320 g/L) as a risk factor for higher platelet reactivity, which might be only of minor clinical importance.…”

Section: Discussionmentioning

confidence: 95%

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Platelet reactivity patterns in patients treated with dual antiplatelet therapy

Winter

Schneeweiss

Cremer

et al. 2019

Eur J Clin Investigation

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Aim The aim of the present study was to investigate the patterns of platelet reactivity and discriminators of therapeutic response to dual antiplatelet therapy (DAPT) with aspirin and ticagrelor or prasugrel in patients with acute coronary syndrome (ACS). Design In this multicentre prospective observational study, 492 patients with ACS were enrolled. Platelet aggregation was determined by multiple electrode aggregometry after stimulation with adenosine diphosphate (ADP) or arachidonic acid (AA) as agonists in the maintenance phase of treatment with prasugrel or ticagrelor. Results Age emerged as the strongest variable influencing aspirin response status: The mean AA‐induced platelet aggregation in patients <49 years of age was 49% higher than in those >49 years (13.1 U vs 8.8 U; P = 0.011). The second strongest discriminator of aspirin response was sex: Male patients had a 40% higher AA‐induced platelet aggregation values than female patients (9.5 U vs 6.8 U; P = 0.026). Platelet count emerged as the only variable influencing ADP antagonists response status showing that patients with platelet count >320 g/L displayed higher ADP‐induced platelet aggregation. About 12% of patients had high on‐treatment platelet reactivity (HTPR) to aspirin, 3% and 4% a HTPR to prasugrel and ticagrelor, respectively, and only 2% displayed HTPR to dual antiplatelet therapy. Conclusion When potent platelet inhibitors as prasugrel and ticagrelor are administered with aspirin, HTPR to DAPT plays only a marginal role.

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 95%

Platelet reactivity patterns in patients treated with dual antiplatelet therapy

Winter

Schneeweiss

Cremer

et al. 2019

Eur J Clin Investigation

View full text Add to dashboard Cite

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High Risk of Cardiovascular Events in Patients, Biosynthesis of Aspirin-Resistant Thromboxane And The Risk Of Stroke, Myocardial Infarction Or Death

Rehman¹,

Shah

Nabi

et al. 2022

PBMJ

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In a higher-risk group, we investigated if aspirin resistance, which is defined as inability to reduce production of thromboxane, enhanced the risk for cardiovascular disease. Methods: The Cardiac Outcome Preventive Assessment Study collected baseline urine samples from 5000 patients. A level of urinary 11-dehydro-thromboxane B2 was measured, which is a marker of within vitro cell generation of thromboxane, in 400 cured patients with aspirin having a cardiovascular death, stroke and infarction, stroke during a 5-year follow-up and in 400 age - and matching sex control subjects, which did not have an event, using a nested case-control design. Result: After accounting for baseline differences, the risks of infarction, strokes, or cardiac mortality rose with every fourth of 11-dihydro-thromboxane B2, with individuals in the top fourth section having a 1.9-fold greater threat than those from the lower portion (“OR, 1.9; 95% CI, 1.3 to 2.8; p=0.009). The upper quartile showed a 2-fold increased myocardial infarction risk ("OR, 2.1; 95% CI, 1.3 to 3.5; p=0.07) and a 3.6-fold elevated risk of cardiac death ("OR, 3.6; 95% CI, 1.78to 7.5; p=0.01) than the lower quartile. Conclusions: the 11-dehydro thromboxane B2 level in urine, better determine the risk of cardiovascular events or cardiovascular death in aspirin-treated patients. These findings also depicts that patients with elevated urine 11-dehydro thromboxane B2 concentrations are more impervious to aspirin, and could profit from greater antiplatelet medications or therapies that even more efficiently stop thromboxane generation in vivo or activities.

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Prevalence of high on-treatment platelet reactivity in patients with chronic kidney disease treated with acetylsalicylic acid for stroke prevention

Cited by 2 publications

References 22 publications

Platelet reactivity patterns in patients treated with dual antiplatelet therapy

Platelet reactivity patterns in patients treated with dual antiplatelet therapy

High Risk of Cardiovascular Events in Patients, Biosynthesis of Aspirin-Resistant Thromboxane And The Risk Of Stroke, Myocardial Infarction Or Death

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