Key result
Obese individuals exhibited significantly greater residual platelet reactivity after 14 days of low-dose aspirin compared to nonobese individuals, including a higher rate of nonzero aggregation to arachidonic acid (8.3% vs 4.9%).
Why the study?
Does obesity affect platelet reactivity and response to low-dose aspirin?
Cohort (n=2,014)
Single-blind
No
Does obesity affect platelet reactivity and response to low-dose aspirin?
Absolute Event Rate: 8.3% vs 4.9%
p-value: p=0.002
Obese individuals have greater native platelet reactivity and retain greater reactivity after suppression by low-dose aspirin, suggesting a potential mechanism for increased cardiovascular risk in this population.
Obesity may blunt low-dose aspirin platelet suppression; leaves open whether this drives events or warrants dose adjustment in trials.
Insufficient platelet function suppression by aspirin is a predictor of cardiovascular events in high-risk patients. The authors assessed the impact of obesity on platelet responsiveness before and after 2 weeks of aspirin 81 mg/d in 2014 people. Obese individuals had greater baseline platelet reactivity. Comparing obese and nonobese individuals after aspirin therapy, results for aggregometry to collagen were 6.7 vs 6.1 ohms, P=.008; aggregometry to adenosine diphosphate were 13.1 vs 11.8 ohms,P<.0001; aggregometry to arachidonic acid (AA) were 4.9% vs 8.3% nonzero aggregation, P=.002; urinary excretion of 11-dehydro-thromboxane B2 (Tx-M) were 4.9% vs 8.3% nonzero aggregation, P=.002; and aspirin resistance were 26.% vs 20.5%, P=.002; respectively. These remained significantly different for AA aggregation and Tx-M excretion after adjustment for covariates. Obese individuals have greater native platelet reactivity and retain greater reactivity after suppression by aspirin.
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Bordeaux et al. (2009) conducted a cohort in Family history of premature coronary artery disease (n=2,014). Obesity vs. Nonobese (BMI < 30 kg/m2) was evaluated on Nonzero platelet aggregation to arachidonic acid after aspirin (p=0.002). Obese individuals exhibited significantly greater residual platelet reactivity after 14 days of low-dose aspirin compared to nonobese individuals, including a higher rate of nonzero aggregation to arachidonic acid (8.3% vs 4.9%).
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