Key result
Coadministration of statins was associated with significantly lower residual serum TXB2 levels compared to nonusers, countering the inadequate aspirin response observed in 14% of the overall cohort.
Why the study?
Does the coadministration of statins reduce residual platelet thromboxane B2 production in high-risk cardiovascular patients chronically treated with aspirin?
Observational (n=182)
Does the coadministration of statins reduce residual platelet thromboxane B2 production in high-risk cardiovascular patients chronically treated with aspirin?
Coadministration of statins in patients on chronic aspirin therapy reduces residual thromboxane B2 production, potentially improving aspirin's antiplatelet efficacy.
May support statin co-use to optimize aspirin response; leaves open confirmation of outcome benefits in randomized trials.
We studied the influence of cardiovascular (CV) risk factors, previous CV events, and cotreatments with preventive medicines, on residual platelet thromboxane (TX)B2 production in 182 patients chronically treated with enteric coated (EC)‐aspirin (100 mg/day). The response to aspirin was also verified by assessing arachidonic acid‐induced platelet aggregation and urinary 11‐dehydro‐TXB2 levels. Residual serum TXB2 levels exceeded the upper limit value for an adequate aspirin response in 14% of individuals. This phenomenon was detected at 12 hours after dosing with aspirin. The coadministration of statins (mostly atorvastatin) was an independent predictor of residual serum TXB2 levels, and the percentage of patients with enhanced values was significantly lower in statin users vs. nonusers. We provide evidence in vitro that atorvastatin reduced residual TXB2 generation by increasing the extent of acetylation of platelet COX‐1 by aspirin. In conclusion, the coadministration of statins may counter the mechanisms associated with reduced bioavailability of aspirin detected in some individuals with CV disease.
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Tacconelli et al. (2018) conducted an observational in High-risk for cardiovascular disease (n=182). Statin coadministration vs. Nonusers of statins was evaluated on Residual serum TXB2 levels. Coadministration of statins was associated with significantly lower residual serum TXB2 levels compared to nonusers, countering the inadequate aspirin response observed in 14% of the overall cohort.
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