title: Post interventional cardiology urinary thromboxane correlates with PlateletMapping detected aspirin resistance.
abstract: 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.
authors: Department of Anesthesiology, University of Tennessee Graduate School of Medicine, Knoxville, Tennessee 37920 USA. rccarrol@mc.utmck.edu
authors: Roger C
authors: RC
authors: Carroll
authors: Ronald E
authors: RE
authors: Worthington
authors: Robert M
authors: RM
authors: Craft
authors: Carolyn C
authors: CC
authors: Snider
authors: Patrick A
authors: PA
authors: Dakin
authors: Dale C
authors: DC
authors: Wortham
authors: Jason
authors: J
authors: Scott
authors: Ashley
authors: A
authors: Jarrett
mesh_terms: 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
chemical_list: D016718:Arachidonic Acid; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D001092:Arachidonate 12-Lipoxygenase; D001093:Arachidonate 15-Lipoxygenase; D001241:Aspirin