title: Comparison between urinary 11-dehydrothromboxane B2 detection and platelet Light Transmission Aggregometry (LTA) assays for evaluating aspirin response in elderly patients with coronary artery disease.
abstract: Aspirin is widely used in the primary and secondary prevention of cardiovascular diseases. The aim of our study was to compare between two established methods of aspirin response, urinary 11-dehydrothromboxane B2 (11dhTXB2) and platelet Light Transmission Aggregometry (LTA) assays in elderly Chinese patients with coronary artery disease (CAD), and to investigate the clinical significance of both methods in predicting cardiovascular events. Urinary 11dhTxB2 assay and arachidonic acid-induced (AA, 0.5mg/ml) platelet aggregation by Light Transmission Aggregometry (LTAAA) assay were measured to evaluate aspirin responses. High-on aspirin platelet reactivity (HAPR) was defined as urinary 11dhTxB2>1500pg/mg or AA-induced platelet aggregation≥15.22%-the upper quartile of our enrolled population. The two tests showed a poor correlation for aspirin inhibition (r=0.063) and a poor agreement in classifying HAPR (kappa=0.053). With a mean follow-up time of 12months, cardiovascular events occurred more frequently in HAPR patients who were diagnosed by LTA assay as compared with no-HAPR patients (22.5% versus 10.6%, P=0.039, OR=2.45, 95% CI=1.06-5.63). However, the HAPR status, as determined by urinary 11dTXB2 measurement, did not show a significant correlation with outcomes.
authors.affiliation: Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.
authors.forename: Tengfei
authors.initials: T
authors.lastname: Liu
authors.affiliation: Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.
authors.forename: Jingwei
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.
authors.forename: Xiahuan
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Geriatrics, Peking University First Hospital, Beijing 100034, China.
authors.forename: Xueru
authors.initials: X
authors.lastname: Feng
authors.affiliation: Department of Medicine (Division of Genomic Medicine), The George Washington University School of Medicine and Health Sciences, Washington DC 20037, USA.
authors.forename: Sidney W
authors.initials: SW
authors.lastname: Fu
authors.affiliation: Department of Medicine (Division of Genomic Medicine), The George Washington University School of Medicine and Health Sciences, Washington DC 20037, USA.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: McCaffrey
authors.affiliation: Department of Geriatrics, Peking University First Hospital, Beijing 100034, China. Electronic address: meilinliu@yahoo.com.
authors.forename: Meilin
authors.initials: M
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D005260:Female; D006801:Humans; D008297:Male; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D010979:Platelet Function Tests / Q000379:methods* / Q000706:statistics & numerical data; D013929:Thromboxane B2 / Q000031:analogs & derivatives* / Q000652:urine; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D016718:Arachidonic Acid; D013929:Thromboxane B2; C049235:11-dehydro-thromboxane B2; D001241:Aspirin
keywords: 11-Dehydrothromboxane B2 (11dhTxB2); Aspirin; Coronary artery disease (CAD); High-on aspirin platelet reactivity (HAPR); Light Transmission Aggregometry (LTA)