Zhang JW, et al. – The goal of this investigation was to identify relative risk factors of high on–aspirin platelet reactivity (HAPR) in elderly patients with coronary artery disease. Findings showed an independent correlation of serum uric acid (SUA), platelet count, hematocrit and P2Y12 receptor inhibitors use with HAPR. Data indicated that these parameters might provide novel therapeutic targets for optimizing antiplatelet therapy.

Methods

• Researchers enrolled in this study elderly, hospitalized coronary artery disease patients on regular aspirin treatment from January 2014 to September 2016.
• They gathered medical records of each patient , including demographic information, cardiovascular risk factors, concomitant drugs and routine biological parameters.
• They measured arachidonic acid (AA, 0.5 mg/mL) and adenosine diphosphate (ADP, 5 µmol/L) induced platelet aggregation via light transmission assay (LTA) to assess antiplatelet responses, referred as LTA–AA and LTA–ADP.

Results

• This study included a total of 275 elderly patients, with mean age of 77.2±8.1 years, and males accounted for 81.8%.
• HAPR was defined as LTA–AA in the upper quartile of the enrolled population.
• Findings showed that HAPR patients tended to have lower renal function (P=0.052).
• Researchers observed higher serum uric acid (SUA) level, as well as lower platelet count, hemoglobin and hematocrit in HAPR patients, with a higher proportion of diuretics use (P<0.05).
• It was shown in multivariate analysis that SUA (OR: 1.004, 95% CI: 1.000–1.007, P=0.048), platelet count (OR: 0.994, 95% CI: 0.989–1.000, P=0.045), hematocrit (OR: 0.921, 95% CI: 0.864–0.981, P=0.011) and concomitant P2Y12 receptor inhibitors use (OR: 1.965, 95% CI: 1.075–3.592, P=0.028) were correlated with HAPR.
• In addition, Spearman’s correlation analysis showed an inverse association of LTA–AA with hematocrit (r=-0.234, P<0.001), hemoglobin (r=-0.209, P<0.001) and estimated glomerular filtration rate (r=-0.132, P=0.031).