Increased bodyweight and inadequate response to aspirin in individuals with coronary artery disease.

Autor: Furtado RHM; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil.; TIMI Study Group - Brigham and Women's Hospital, Boston, MA, USA., Giugliano RP; TIMI Study Group - Brigham and Women's Hospital, Boston, MA, USA., Dalcoquio TF; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Arantes FBB; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil.; Universidade Federal de Uberlandia, Uberlandia, Minas Gerais, Brazil., Barbosa CJDG; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil.; Hospital do Coracao do Brasil, Brasília, Distrito Federal, Brazil., Genestreti PRR; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Franci A; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Menezes FR; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Nakashima CAK; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Scanavini Filho MA; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Ferrari AG; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Salsoso R; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Baracioli LM; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil., Nicolau JC; Instituto do Coracao (InCor), Unidade de Coronariopatia Aguda, Hospital das Clinicas, Faculdade de Medicina (HCFMUSP), Universidade de Sao Paulo, São Paulo, Brazil. jose.nicolau@incor.usp.br.
Jazyk: angličtina
Zdroj: Journal of thrombosis and thrombolysis [J Thromb Thrombolysis] 2019 Aug; Vol. 48 (2), pp. 217-224.
DOI: 10.1007/s11239-019-01830-z
Abstrakt: Recent reports have suggested that aspirin effect might be influenced by bodyweight, with decreased efficacy in heavier individuals. We investigated the influence of bodyweight on aspirin pharmacodynamics in two independent datasets of patients taking non-enteric coated aspirin 100 mg QD for coronary artery disease (CAD). In the first dataset, 368 patients had their platelet aggregation assessed using VerifyNow Aspirin and measured in Aspirin Reaction Units (ARU). In the second dataset, 70 patients had serum thromboxane B2 (TXB2) dosage assessed by an ELISA assay and measured in pg/mL. Platelet aggregation was independently associated with bodyweight, with 8.41 (95% CI 1.86-14.97; adjusted p-value = 0.012) increase in ARU for every 10 kg. Furthermore, the rate of non-response to aspirin (defined as ARU ≥ 550) was significantly associated with increased bodyweight (adjusted p-value = 0.007), with OR = 1.23 (95% CI 1.06-1.42) for every 10 kg. Similar results were found considering body mass index (in kg/m 2 ), with 15.5 (95% CI 5.0 to 25.9; adjusted p-value = 0.004) increase in ARU for every 10 kg and non-response OR = 1.43 (95% CI 1.13 to 1.81, adjusted p-value = 0.003) for every 5 kg/m 2 . Moreover, serum TXB2 was higher in patients weighting more than 70 kg (222.6 ± 62.9 versus 194.9 ± 61.9 pg/mL; adjusted p-value = 0.018). In two different datasets of patients with CAD on non-enteric coated aspirin 100 mg QD, increased bodyweight was independently associated with impaired response to aspirin.
Databáze: MEDLINE
Externí odkaz: