Key result
Fourteen genetic variants including P2RY1 and MDR1 are linked to aspirin resistance.
Why the study?
Aspirin is used to prevent CVD, but patients may experience treatment failure due to genetic variants that alter drug metabolism and cause aspirin resistance.
Do specific genetic variants impact the risk of aspirin resistance in patients taking aspirin for cardiovascular disease prevention?
Systematic Review (n=10,873)
Do specific genetic variants impact the risk of aspirin resistance in patients taking aspirin for cardiovascular disease prevention?
Several genetic variants are significantly associated with aspirin resistance, highlighting the potential role of pharmacogenetics in personalizing antiplatelet therapy to prevent cardiovascular events.
Answers are grounded in this paper and cite their sources.
May support pharmacogenetic testing for aspirin resistance; leaves open effects on clinical outcomes and therapy changes.
Background Pharmacogenetics promises better control of diseases such as cardiovascular disease (CVD). Acetylsalicylic acid, aspirin, prevents the formation of an activating agent of platelet aggregation and vasoconstriction, and it is used to prevent CVD. Nevertheless, patients may have treatment failure due to genetic variants that modify the metabolism of the drug causing aspirin resistance (AR). Objectives To realize a systematic literature review to determine the impact of genetic variants on AR. Methods Articles published in the MEDLINE/PubMed, Cochrane, Scopus, LILACS, and SCIELO databases were systematically screened. A total of 290 articles were identified and 269 articles were excluded because they did not comply with the previously established inclusion criteria. A total of 20 case-control studies and 1 cohort was included. Results The genetic variants rs1126643 (ITGA2), rs3842787 (PTGS1), rs20417 (PTGS2), and rs5918 (ITGB3) were the most studied. As for relevance, of the 64 genetic variants evaluated by the articles, 14 had statistical significance (p < 0.05; 95% confidence interval [CI]) in at least one article. Among them, the following have had unanimous results: rs1371097 (P2RY1), rs1045642 (MDR1), rs1051931 and rs7756935 (PLA2G7), rs2071746 (HO1), rs1131882 and rs4523 (TBXA2R), rs434473 (ALOX12), rs9315042 (ALOX5AP), and rs662 (PON1), while these differ in real interference in AR: rs5918 (ITGB3), rs2243093 (GP1BA), rs1330344 (PTGS1), and rs20417 (PTGS2). As study limitations, we highlight the nonuniform methodologies of the analyzed articles and population differences. Conclusion It is noteworthy that pharmacogenetics is an expanding area. Therefore, further studies are needed to better understand the association between genetic variants and AR.
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Silva et al. (2023) conducted a systematic review in Aspirin resistance in cardiovascular disease (n=10,873). Aspirin vs. Aspirin sensitive patients was evaluated on Aspirin resistance. Fourteen genetic variants, including rs1371097 (P2RY1) and rs1045642 (MDR1), demonstrated statistically significant associations with aspirin resistance across 21 studies.
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