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Thromb Haemost 2011; 105(02): 336-344
DOI: 10.1160/TH10-02-0082
Platelets and Blood Cells
Schattauer GmbH

24-hour time-dependent aspirin efficacy in patients with stable coronary artery disease

Patrick Henry
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Adeline Vermillet
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Bernadette Boval
2   Angio-hematology, Lariboisiere hospital, AP-HP and University Paris VIIDiderot, Paris, France
,
Carine Guyetand
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Thibaut Petroni
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Jean-Guillaume Dillinger
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Georgios Sideris
1   Cardiology & INSERM U942, Lariboisiere hospital, AP-HP and University Paris VII-Diderot, Paris, France
,
Claire Bal dit Sollier
2   Angio-hematology, Lariboisiere hospital, AP-HP and University Paris VIIDiderot, Paris, France
,
Ludovic Drouet
2   Angio-hematology, Lariboisiere hospital, AP-HP and University Paris VIIDiderot, Paris, France
› Author Affiliations Financial support: This work was supported by the Institute of Blood and Vessels (account n°LTA/003).
Further Information

Publication History

Received: 01 February 2010

Accepted after major revision: 22 October 2010

Publication Date:
25 November 2017 (online)

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Summary

Aspirin-induced cyclooxygenase (COX)-1 acetylation is irreversible and it is assumed that the platelet thromboxane-A2 aggregation pathway is inhibited for at least 24 hours (h) after aspirin ingestion. However, time course of biological efficacy of daily low-dose aspirin has rarely been assessed in patients with coronary artery disease (CAD). We aimed to assess the 24-h biological efficacy of daily low-dose aspirin in CAD patients. The peak and trough (2 h –24 h) effect of a chronic treatment with once daily dose aspirin were studied in 150 consecutive stable CAD patients. The main outcome measure was light transmission aggregometry (LTA) triggered with 0.5 mg/ml arachidonic acid (AA). In the last 47 consecutive patients, additional tests were conducted at 6, 12, 16, 20 h after last aspirin administration. 4.7% of the patients had significant aggregation (>20% maximal intensity LTA-AA) 2 h after aspirin ingestion and 24.7% at 24 h (p<0.0001). The more precise assessments in the last 47 patients showed that significant platelet aggregation progressively reappeared with time after aspirin intake (2 h – 4% of patients, 6 h – 4%, 12 h – 11%, 16 h – 16%, 20 h – 19% and 24 h – 28%). Concordant results were observed using production of thromboxane-B2 and other techniques evaluating AA-induced platelet aggregation/activation. No significant differences were found between lower (75–100 mg/day) and higher (>100 mg/day) dose aspirin. Such aspirin «resistance» at 24 h after ingestion was related to biological inflammatory markers, current smoking and diabetes. In conclusion, once daily aspirin does not provide stable 24-h antiplatelet protection in a significant proportion of CAD patients. Any biological assessment of aspirin efficacy should take time since last aspirin intake into consideration.

Keywords

Platelet aggregation - aspirin - aspirin resistance - coronary artery disease
 

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