A comparison of verifynow® with plateletmapping®-detected aspirin resistance and correlation with urinary thromboxane

Roger C. Carroll, Robert Craft, Carolyn C. Snider, Venkata R. Aligeti, Dale Wortham

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

BACKGROUND: Aspirin-resistant platelet activation in whole blood is attributable to a transcellular pathway not detected by isolated platelet aggregometry. Aspirin resistance as defined by urinary thromboxane levels is associated with increased risk for myocardial infarction or cardiac death. Whole blood point-of-care assays may also detect aspirin resistance. METHODS:: We compared PlateletMapping® with VerifyNow® for detecting aspirin resistance in 200 patients undergoing invasive cardiac procedures. This included 10 patients not receiving aspirin therapy for comparison. The assay results were correlated with urinary 11-dehydro-thromboxane B2 collected 2 to 8 hours after the procedure. RESULTS:: PlateletMapping detected aspirin resistance in 32% of patients. VerifyNow detected aspirin resistance in 6% of patients. A patient's compliance with aspirin therapy was confirmed by a <20% aggregation response to arachidonic acid by light transmission aggregometry. Aspirin-resistant patients as determined by PlateletMapping had significantly (P < 0.001) higher urinary 11-dehydro-thromboxane B2 levels than aspirin-sensitive patients but significantly (P = 0.001) lower levels than patients not receiving aspirin therapy. There was no significant difference in urinary 11-dehydro-thromboxane B2 for aspirin-resistant compared with aspirin-sensitive patients as determined by VerifyNow, but the confidence intervals were wide. There was no significant correlation of resistance as defined by PlateletMapping with aspirin dose. However, there was significant increased aspirin sensitivity with clopidogrel (0.0006) or statin (0.004) cotherapies. There also was a significant correlation of smoking with aspirin resistance. CONCLUSIONS:: These results indicate that PlateletMapping could be a useful point-of-care assay to identify aspirin-resistant patients for better perioperative risk stratification and management.

Original languageEnglish (US)
Pages (from-to)282-286
Number of pages5
JournalAnesthesia and Analgesia
Volume116
Issue number2
DOIs
StatePublished - Feb 1 2013

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Thromboxanes
Aspirin
Point-of-Care Systems
clopidogrel
Transcytosis
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Platelet Activation
Risk Management
Patient Compliance
Arachidonic Acid

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Cite this

A comparison of verifynow® with plateletmapping®-detected aspirin resistance and correlation with urinary thromboxane. / Carroll, Roger C.; Craft, Robert; Snider, Carolyn C.; Aligeti, Venkata R.; Wortham, Dale.

In: Anesthesia and Analgesia, Vol. 116, No. 2, 01.02.2013, p. 282-286.

Research output: Contribution to journalArticle

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abstract = "BACKGROUND: Aspirin-resistant platelet activation in whole blood is attributable to a transcellular pathway not detected by isolated platelet aggregometry. Aspirin resistance as defined by urinary thromboxane levels is associated with increased risk for myocardial infarction or cardiac death. Whole blood point-of-care assays may also detect aspirin resistance. METHODS:: We compared PlateletMapping{\circledR} with VerifyNow{\circledR} for detecting aspirin resistance in 200 patients undergoing invasive cardiac procedures. This included 10 patients not receiving aspirin therapy for comparison. The assay results were correlated with urinary 11-dehydro-thromboxane B2 collected 2 to 8 hours after the procedure. RESULTS:: PlateletMapping detected aspirin resistance in 32{\%} of patients. VerifyNow detected aspirin resistance in 6{\%} of patients. A patient's compliance with aspirin therapy was confirmed by a <20{\%} aggregation response to arachidonic acid by light transmission aggregometry. Aspirin-resistant patients as determined by PlateletMapping had significantly (P < 0.001) higher urinary 11-dehydro-thromboxane B2 levels than aspirin-sensitive patients but significantly (P = 0.001) lower levels than patients not receiving aspirin therapy. There was no significant difference in urinary 11-dehydro-thromboxane B2 for aspirin-resistant compared with aspirin-sensitive patients as determined by VerifyNow, but the confidence intervals were wide. There was no significant correlation of resistance as defined by PlateletMapping with aspirin dose. However, there was significant increased aspirin sensitivity with clopidogrel (0.0006) or statin (0.004) cotherapies. There also was a significant correlation of smoking with aspirin resistance. CONCLUSIONS:: These results indicate that PlateletMapping could be a useful point-of-care assay to identify aspirin-resistant patients for better perioperative risk stratification and management.",
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