Post interventional cardiology urinary thromboxane correlates with PlateletMapping detected aspirin resistance.
BACKGROUND
We have previously defined aspirin resistance detected by TEG PlateletMapping using arachidonic acid (AA). This aspirin resistance is observed as platelet activation (>20%) by AA in whole blood, even though the isolated platelets are inhibited by aspirin. This platelet activation in whole blood is due to a transcellular pathway mediated by platelets and leukocytes.


METHODS
To determine if this PlateletMapping assay of aspirin resistance on pre-procedure blood samples correlated with an in vivo response we assayed the first voided urine samples collected 2-8 hours post interventional cardiology procedures for 11-dehydro thromboxane B2.


CONCLUSIONS
We detected 27 aspirin resistant patients out of a total of 81 (33%), in agreement with our previous study. All of these patients were on aspirin therapy, confirmed by a <20% aggregation response to AA by light transmission platelet aggregometry using isolated platelet rich plasma. Aspirin resistant patients urine samples (14 out of a total of 60 patients analyzed) contained significantly (P=0.008) higher 11-dehydro thromboxane B2 levels than the other 46 aspirin sensitive patients urine samples. Since our previous study implicated 12- and 15-lipoxygenases in this pathway, we also assayed for polymorphisms to determine any correlation with aspirin resistance. A correlation was found in a polymorphism affecting the lipoxygenase domain of platelet 12-lipoxygenase. This result indicates that aspirin resistance detected in whole blood by the TEG PlateletMapping assay correlates with a physiological consequence in terms of thromboxane formation. This is the first report of such a correlation.
Carroll
Roger C
RC
Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920 USA. rccarrol@mc.utmck.edu
Worthington
Ronald E
RE
Craft
Robert M
RM
Snider
Carolyn C
CC
Dakin
Patrick A
PA
Wortham
Dale C
DC
Scott
Jason
J
Jarrett
Ashley
A
D001092:Arachidonate 12-Lipoxygenase / Q000494:pharmacology; D001093:Arachidonate 15-Lipoxygenase / Q000494:pharmacology; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000494:pharmacology*; D001792:Blood Platelets / Q000187:drug effects* / Q000502:physiology; D002309:Cardiology / Q000379:methods*; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects* / Q000502:physiology; D010976:Platelet Count / Q000379:methods; D013929:Thromboxane B2 / Q000031:analogs & derivatives* / Q000652:urine
D016718:Arachidonic Acid; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D001092:Arachidonate 12-Lipoxygenase; D001093:Arachidonate 15-Lipoxygenase; D001241:Aspirin