Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease

JW Zhang,1 WW Liu,1 Timothy A McCaffrey,2 XQ He,1 WY Liang,1 XH Chen,1 XR Feng,1 Sidney W Fu,2 ML Liu1 1Department of Geriatrics, Peking University First Hospital, Beijing, China; 2Department of Medicine, George Washington University Medical Center, Washington, DC, USA Objectives: Previous studies...

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Autores principales:	Zhang JW, Liu WW, McCaffrey TA, He XQ, Liang WY, Chen XH, Feng XR, Fu SW, Liu ML
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	high on-aspirin platelet reactivity elderly risk factors Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/c006466b426748b89b4de988d64cc73d
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spelling	oai:doaj.org-article:c006466b426748b89b4de988d64cc73d2021-12-02T03:21:22ZPredictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease1178-1998https://doaj.org/article/c006466b426748b89b4de988d64cc73d2017-08-01T00:00:00Zhttps://www.dovepress.com/predictors-of-high-on-aspirin-platelet-reactivity-in-elderly-patients--peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998JW Zhang,1 WW Liu,1 Timothy A McCaffrey,2 XQ He,1 WY Liang,1 XH Chen,1 XR Feng,1 Sidney W Fu,2 ML Liu1 1Department of Geriatrics, Peking University First Hospital, Beijing, China; 2Department of Medicine, George Washington University Medical Center, Washington, DC, USA Objectives: Previous studies have illustrated the link between high on-aspirin platelet reactivity (HAPR) with increasing thrombotic risks. The aim of our study was to investigate relative risk factors of HAPR in elderly patients with coronary artery disease.Methods: Elderly, hospitalized coronary artery disease patients on regular aspirin treatment were enrolled from January 2014 to September 2016. Medical records of each patient were collected, including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters. Arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation were measured via light transmission assay (LTA) to evaluate antiplatelet responses, referred as LTA–AA and LTA–ADP.Results: A total of 275 elderly patients were included, with mean age of 77.2±8.1 years, and males accounted for 81.8%. HAPR was defined as LTA–AA in the upper quartile of the enrolled population. HAPR patients tended to have lower renal function (P=0.052). Higher serum uric acid (SUA) level, as well as lower platelet count, hemoglobin and hematocrit were observed in HAPR patients, with a higher proportion of diuretics use (P<0.05). Multivariate analysis revealed that SUA (OR: 1.004, 95% CI: 1.000–1.007, P=0.048), platelet count (OR: 0.994, 95% CI: 0.989–1.000, P=0.045), hematocrit (OR: 0.921, 95% CI: 0.864–0.981, P=0.011) and concomitant P2Y12 receptor inhibitors use (OR: 1.965, 95% CI: 1.075–3.592, P=0.028) were correlated with HAPR. Spearman’s correlation analysis demonstrated an inverse association of LTA–AA with hematocrit (r=−0.234, P<0.001), hemoglobin (r=−0.209, P<0.001) and estimated glomerular filtration rate (r=−0.132, P=0.031).Conclusion: SUA, platelet count, hematocrit and P2Y12 receptor inhibitors use were independently correlated with HAPR. These parameters might provide novel therapeutic targets for optimizing antiplatelet therapy. Keywords: aspirin, platelet reactivity, elderly, risk factors, coronary artery diseaseZhang JWLiu WWMcCaffrey TAHe XQLiang WYChen XHFeng XRFu SWLiu MLDove Medical Pressarticlehigh on-aspirin platelet reactivityelderlyrisk factorsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1271-1279 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	high on-aspirin platelet reactivity elderly risk factors Geriatrics RC952-954.6
spellingShingle	high on-aspirin platelet reactivity elderly risk factors Geriatrics RC952-954.6 Zhang JW Liu WW McCaffrey TA He XQ Liang WY Chen XH Feng XR Fu SW Liu ML Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
description	JW Zhang,1 WW Liu,1 Timothy A McCaffrey,2 XQ He,1 WY Liang,1 XH Chen,1 XR Feng,1 Sidney W Fu,2 ML Liu1 1Department of Geriatrics, Peking University First Hospital, Beijing, China; 2Department of Medicine, George Washington University Medical Center, Washington, DC, USA Objectives: Previous studies have illustrated the link between high on-aspirin platelet reactivity (HAPR) with increasing thrombotic risks. The aim of our study was to investigate relative risk factors of HAPR in elderly patients with coronary artery disease.Methods: Elderly, hospitalized coronary artery disease patients on regular aspirin treatment were enrolled from January 2014 to September 2016. Medical records of each patient were collected, including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters. Arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation were measured via light transmission assay (LTA) to evaluate antiplatelet responses, referred as LTA–AA and LTA–ADP.Results: A total of 275 elderly patients were included, with mean age of 77.2±8.1 years, and males accounted for 81.8%. HAPR was defined as LTA–AA in the upper quartile of the enrolled population. HAPR patients tended to have lower renal function (P=0.052). Higher serum uric acid (SUA) level, as well as lower platelet count, hemoglobin and hematocrit were observed in HAPR patients, with a higher proportion of diuretics use (P<0.05). Multivariate analysis revealed that SUA (OR: 1.004, 95% CI: 1.000–1.007, P=0.048), platelet count (OR: 0.994, 95% CI: 0.989–1.000, P=0.045), hematocrit (OR: 0.921, 95% CI: 0.864–0.981, P=0.011) and concomitant P2Y12 receptor inhibitors use (OR: 1.965, 95% CI: 1.075–3.592, P=0.028) were correlated with HAPR. Spearman’s correlation analysis demonstrated an inverse association of LTA–AA with hematocrit (r=−0.234, P<0.001), hemoglobin (r=−0.209, P<0.001) and estimated glomerular filtration rate (r=−0.132, P=0.031).Conclusion: SUA, platelet count, hematocrit and P2Y12 receptor inhibitors use were independently correlated with HAPR. These parameters might provide novel therapeutic targets for optimizing antiplatelet therapy. Keywords: aspirin, platelet reactivity, elderly, risk factors, coronary artery disease
format	article
author	Zhang JW Liu WW McCaffrey TA He XQ Liang WY Chen XH Feng XR Fu SW Liu ML
author_facet	Zhang JW Liu WW McCaffrey TA He XQ Liang WY Chen XH Feng XR Fu SW Liu ML
author_sort	Zhang JW
title	Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
title_short	Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
title_full	Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
title_fullStr	Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
title_full_unstemmed	Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
title_sort	predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/c006466b426748b89b4de988d64cc73d
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Predictors of high on-aspirin platelet reactivity in elderly patients with coronary artery disease

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