title: High frequency of aspirin resistance in patients with nephrotic syndrome.
abstract: BACKGROUND
  Aspirin has a beneficial role in prevention of cardiovascular and thromboembolic events. Patients may experience thromboembolic events despite aspirin treatment, a phenomenon called aspirin resistance. We evaluated the frequency of aspirin resistance and its correlation with clinical and biochemical parameters among patients with nephrotic syndrome (NS).
  
  
  METHODS
  A total of 83 patients (50 males, 33 females, age range 18-79 years) with NS using aspirin 100 mg/day were included in the study. Demographic information and aetiology of NS based on the histology of a renal biopsy were recorded for each patient. Blood samples were drawn to investigate the association of aspirin resistance with inflammation and thrombotic risk factors. Aspirin resistance was defined as a normal collagen/epinephrine closure time<159 s using a platelet function analyzer (PFA-100).
  
  
  RESULTS
  Aspirin resistance was determined in 51 patients (61.4%). The number of patients exposed to azathioprine therapy was significantly higher in the aspirin-sensitive group (P=0.043), whereas patients exposed to cyclosporine therapy were significantly higher in the aspirin-resistant group (P=0.017). More patients in the aspirin-resistant group were on angiotensin-converting enzyme inhibitor therapy compared with the aspirin-sensitive group (P=0.024). The aspirin-resistant group showed significantly higher serum low-density lipoprotein cholesterol (LDL-C) (151±47 versus 104±21 mg/dL; P<0.001), triglyceride levels (192±116 versus 134±82 mg/dL; P=0.015) and glomerular filtration rates (91.8±43.0 versus 74.0±35.6 mL/min/1.73 m2; P=0.044) compared with the aspirin-sensitive group. In multivariate analysis, LDL-C was the only parameter associated independently with aspirin resistance [odds ratio (OR) 1.04, 95% confidence interval (CI) 1.02-1.06; P=0.004].
  
  
  CONCLUSIONS
  A significant number of patients with NS are resistant to aspirin therapy. Serum LDL-C level is closely associated with aspirin resistance in NS.
authors.affiliation: Department of Nephrology, Ankara Numune Research and Education Hospital, and Department of Endocrinology, Ankara University School of Medicine, Ankara, Turkey. drakomd@yahoo.com
authors.forename: Hadim
authors.initials: H
authors.lastname: Akoglu
authors.forename: Kemal
authors.initials: K
authors.lastname: Agbaht
authors.forename: Serhan
authors.initials: S
authors.lastname: Piskinpasa
authors.forename: Mesude Y
authors.initials: MY
authors.lastname: Falay
authors.forename: Fatih
authors.initials: F
authors.lastname: Dede
authors.forename: Gulsum
authors.initials: G
authors.lastname: Ozet
authors.forename: Ali Riza
authors.initials: AR
authors.lastname: Odabas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000150:complications / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D010979:Platelet Function Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013927:Thrombosis / Q000175:diagnosis / Q000209:etiology*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin