title: Laboratory aspirin resistance reversibility in diabetic patients: a pilot study using different pharmaceutical formulations.
abstract: OBJECTIVE
  Aspirin resistance occurs most frequently in diabetic patients and is associated with poor prognosis. The purpose of this study was to evaluate the prevalence of aspirin resistance in a cohort of diabetic patients and whether it can be reversed using more bioavailable aspirin formulations.
  
  
  METHODS
  Platelets function of 163 diabetic patients taking acetyl salicylic acid (ASA) 100 mg daily has been evaluated with PFA100 and VerifyNow. Patients found resistant by at least one test received an infusion of 288 mg of lysine acetylsalicylate (Flectadol®) corresponding to ASA 160 mg. Platelets function was measured again after 1 and 24 h. Patients whose the resistance was reversed received 288 mg of soluble salt of lysine acetylsalicylate (Cardirene 160®) corresponding to ASA160 mg instead of aspirin and their aggregation status was re-evaluated after 1 month of therapy.
  
  
  RESULTS
  Prevalence of aspirin resistance in our population was 18,4 % (30/163). In 27 out of 30 patients (90 %) aspirin resistance was reversed within 24 h from the infusion. 25 out of 27 patients (92 %) were found fully aspirin-sensitive after 1 month of oral therapy with soluble salt; two patients were found with borderline value. No adverse reactions were observed.
  
  
  CONCLUSIONS
  A significant number of diabetic patients are resistant to aspirin therapy. A single intravenous dose of lysine acetylsalicylate can reverse the platelet hyper-aggregability and laboratory aspirin resistance in large majority of patients. The efficacy of antiaggregation can be maintained by chronic therapy with an oral drug with a more favourable pharmacokinetic profile.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Grimaldi
authors.forename: Marta
authors.initials: M
authors.lastname: Bisi
authors.forename: Enrica
authors.initials: E
authors.lastname: Lonni
authors.forename: Eloise
authors.initials: E
authors.lastname: Beggiato
authors.forename: Alessandra
authors.initials: A
authors.lastname: Valpreda
authors.forename: Marco Francesco
authors.initials: MF
authors.lastname: Lococo
authors.forename: Enrico
authors.initials: E
authors.lastname: Dosio
authors.forename: Davide Giacomo
authors.initials: DG
authors.lastname: Presutti
authors.forename: Milena
authors.initials: M
authors.lastname: Tagliabue
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
mesh_terms: D000368:Aged; D001241:Aspirin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002626:Chemistry, Pharmaceutical; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D007753:Laboratories; D008239:Lysine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
chemical_list: D010975:Platelet Aggregation Inhibitors; D008239:Lysine; D001241:Aspirin; C010395:acetylsalicylic acid lysinate