Wenyi Liang1, Peng Zhang1, Meilin Liu2. 1. Department of Geriatrics, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China. 2. Department of Geriatrics, Peking University First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, People's Republic of China. liumeilin@hotmail.com.
Abstract
BACKGROUND: Aspirin is the key treatment in the secondary prevention of atherosclerotic cardiovascular disease. High on-treatment platelet reactivity (HTPR) to aspirin has been reported to partially account for the enhanced risk of thrombotic events. In particular, HTPR has been described more frequently among elderly patients. The aim of this study was to identify the clinical and biological factors associated with HTPR in a real-life elderly population. METHODS: In this retrospective study, elderly patients with atherosclerotic cardiovascular disease on regular aspirin treatment were enrolled. Cardiovascular risk factors, routine biological parameters, comorbidities, and concomitant medications were recorded. The upper quartile of the platelet aggregation rate, determined by light transmission aggregometry with arachidonic acid, was defined as the HTPR group. RESULTS: A total of 304 patients were included (mean age 77 ± 8 years, 76% men). Patients in the HTPR group were older than the patients in the non-HTPR group (mean age: 79 ± 7 vs. 76 ± 8 years, p = 0.008). Patients with moderately decreased estimated glomerular filtration rate (eGFR) had a higher frequency of HTPR than patients with slightly decreased eGFR or normal eGFR (35.8, 22.5, 12.2%, respectively, p < 0.05). In multivariate analysis, an independent risk factor for HTPR was the eGFR (OR: 0.984, 95% CI: 0.980-0.988, p < 0.001). CONCLUSIONS: Advanced age and decreased eGFR are correlated with poor pharmacodynamic response to aspirin.
BACKGROUND:Aspirin is the key treatment in the secondary prevention of atherosclerotic cardiovascular disease. High on-treatment platelet reactivity (HTPR) to aspirin has been reported to partially account for the enhanced risk of thrombotic events. In particular, HTPR has been described more frequently among elderly patients. The aim of this study was to identify the clinical and biological factors associated with HTPR in a real-life elderly population. METHODS: In this retrospective study, elderly patients with atherosclerotic cardiovascular disease on regular aspirin treatment were enrolled. Cardiovascular risk factors, routine biological parameters, comorbidities, and concomitant medications were recorded. The upper quartile of the platelet aggregation rate, determined by light transmission aggregometry with arachidonic acid, was defined as the HTPR group. RESULTS: A total of 304 patients were included (mean age 77 ± 8 years, 76% men). Patients in the HTPR group were older than the patients in the non-HTPR group (mean age: 79 ± 7 vs. 76 ± 8 years, p = 0.008). Patients with moderately decreased estimated glomerular filtration rate (eGFR) had a higher frequency of HTPR than patients with slightly decreased eGFR or normal eGFR (35.8, 22.5, 12.2%, respectively, p < 0.05). In multivariate analysis, an independent risk factor for HTPR was the eGFR (OR: 0.984, 95% CI: 0.980-0.988, p < 0.001). CONCLUSIONS: Advanced age and decreased eGFR are correlated with poor pharmacodynamic response to aspirin.
Entities:
Keywords:
Age; Aspirin; Atherosclerotic cardiovascular disease; Platelet reactivity; Renal function
Authors: J W Zhang; W W Liu; Timothy A McCaffrey; X Q He; W Y Liang; X H Chen; X R Feng; Sidney W Fu; M L Liu Journal: Clin Interv Aging Date: 2017-08-10 Impact factor: 4.458
Authors: Jamie B Hadley; Marguerite R Kelher; Julia R Coleman; Kathleen K Kelly; Larry J Dumont; Orlando Esparza; Anirban Banerjee; Mitchell J Cohen; Kenneth Jones; Christopher C Silliman Journal: Transfusion Date: 2022-08-05 Impact factor: 3.337