Ex vivo personalization of aspirin therapy in 81 mg non-sensitive patients demonstrated that all 9 compliant patients became sensitive at escalating dosages equivalent to 162 mg or 325 mg.
Observational (n=64)
No
Does ex vivo aspirin dose escalation guided by Light Transmission Aggregometry improve aspirin sensitivity in patients with atherosclerosis who are non-sensitive to 81 mg aspirin?
Ex vivo light transmission aggregometry can successfully identify aspirin non-sensitivity and guide dose escalation to achieve adequate platelet inhibition in patients with atherosclerosis.
Acetylsalicylic acid (ASA), also known as aspirin, appears to be ineffective in inhibiting platelet aggregation in 20–30% of patients. Light transmission aggregometry (LTA) is a gold standard platelet function assay. In this pilot study, we used LTA to personalize ASA therapy ex vivo in atherosclerotic patients. Patients were recruited who were on 81 mg ASA, presenting to ambulatory clinics at St. Michael’s Hospital (n = 64), with evidence of atherosclerotic disease defined as clinical symptoms and diagnostic findings indicative of symptomatic peripheral arterial disease (PAD), with an ankle brachial index (ABI) of 50% stenosis of internal carotid artery on duplex ultrasound (n = 12). ASA compliance was assessed via multisegmented injection-capillary electrophoresis-mass spectrometry based on measuring the predominant urinary ASA metabolite, salicyluric acid. LTA with arachidonic acid was used to test for ASA sensitivity. Escalating ASA dosages of 162 mg and 325 mg were investigated ex vivo for ASA dose personalization. Of the 64 atherosclerotic patients recruited, 8 patients (13%) were non-compliant with ASA. Of ASA compliant patients (n = 56), 9 patients (14%) were non-sensitive to their 81 mg ASA dosage. Personalizing ASA therapy in 81 mg ASA non-sensitive patients with escalating dosages of ASA demonstrated that 6 patients became sensitive to a dosage equivalent to 162 mg ASA and 3 patients became sensitive to a dosage equivalent to 325 mg ASA. We were able to personalize ASA dosage ex vivo in all ASA non-sensitive patients with escalating dosages of ASA within 1 h of testing.
Khan et al. (Mon,) conducted a observational in Atherosclerosis (Peripheral Arterial Disease and Carotid Artery Stenosis) (n=64). Ex vivo aspirin dose escalation vs. 81 mg aspirin (baseline) was evaluated on Aspirin sensitivity (maximal platelet aggregation <20%). Ex vivo personalization of aspirin therapy in 81 mg non-sensitive patients demonstrated that all 9 compliant patients became sensitive at escalating dosages equivalent to 162 mg or 325 mg.