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Correlation of Cardiovascular Risk Factors and Biomarkers With Platelet Reactivity in Coronary Artery Disease

Bobescu, Elena MD, PhD1,2; Covaciu, Alexandru MD1,3,*; Rus, Horatiu MD, PhD1,2; Radoi, Mariana MD, PhD1; Badea, Mihaela PhD4; Moga, Silvia N. MD2,4; Benza, Valentina MD2; Marceanu, Luigi G. MD, PhD1

doi: 10.1097/MJT.0000000000000869
Original Investigation
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Background: Low response to aspirin, aspirin resistance, and high platelet reactivity on aspirin treatment are similar names for lack of response to block arachidonic acid–induced aggregation with aspirin therapy and have an important role in the evolution of coronary artery disease (CAD) with thromboembolic events.

Study Question: Was to evaluate the correlation between cardiovascular risk factors, biomarkers, and low response to aspirin in patients (pts) with CAD.

Study Design: Four hundred pts with CAD were divided into 8 groups of study, consistent with the type of CAD and low response to aspirin. Cardiovascular risk factors and biomarkers—including some of high platelet reactivity, endothelial dysfunction, hypercoagulability, and oxidative stress—were evaluated in correlation with low response to aspirin, defined as on treatment aspirin test (ASPItest) >30U by multiple electrode platelet aggregometry.

Results: In patients with CAD, low response to aspirin was significantly correlated with age older than 65 years, smoking, presence of diabetes mellitus, body mass index >25, hypertension, previous aspirin treatment, low response to clopidogrel, high mean platelets volume and von Willebrand factor activity, low flow-mediated vasodilation, and total antioxidant status (P < 0.01). In unstable angina patients, low response to aspirin was significantly correlated with male sex (P < 0.03). Incidence of other hypercoagulability biomarkers—S Protein, C Protein, Antithrombin III, and V Factor Leiden resistance to activated protein C—was low and not correlated with low response to aspirin.

Conclusions: In CAD, low response to aspirin was significantly correlated with age older than 65 years, smoking, presence of diabetes mellitus, body mass index I >25, hypertension, previous aspirin treatment, and only in unstable angina with male sex. Low response to aspirin was also statistically associated with low response to clopidogrel, high mean platelets volume, high von Willebrand factor activity, low flow-mediated vasodilation, and low total antioxidant status values.

1Department of Medical and Surgical Specialties, Faculty of Medicine, “Transilvania” University, Brasov, Romania;

2Department of Cardiology, Clinic County Emergency Hospital, Brasov, Romania;

3Department of Cardiology, Clinic County Emergency Hospital, Oradea, Romania; and

4Department of Fundamental, Prophylactic and Clinical Disciplines, Faculty of Medicine, “Transilvania” University, Brasov, Romania.

Address for correspondence: Faculty of Medicine, “Transilvania” University Brasov, Str. Nicolae Balcescu Nr 56, Brasov 500019, Romania. E-mail: alexandru.covaciu92@gmail.com

Elaboration of the research design and protocol: E. Bobescu and L. G. Marceanu; acquisition of data: A. Covaciu, H. Rus, S. N. Moga, and V. Benza; analysis and interpretation of the data: E. Bobescu and L. G. Marceanu; writing of the manuscript: E. Bobescu; critical revision of the manuscript for intellectual content: M. Radoi and M. Badea.

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