High Risk of Cardiovascular Events in Patients, Biosynthesis of Aspirin-Resistant Thromboxane And The Risk Of Stroke, Myocardial Infarction Or Death

Biosynthesis of Aspirin-Resistant Thromboxane & Risk of Stroke

Authors

  • Erum Rehman Department of Pharmacology, Peshawar Medical and Dental College, Peshawar
  • Syed Hasnain Ali Shah Department of Pharmacology, Kabir Medical College, Peshawar
  • Muhammad Nabi Institute of Pharmaceutical Sciences, Khyber Medical University, IPS-KMU
  • Zakia Subhan Department of Pharmacology, KMU-IMS Kohat
  • Shah Zaman Department of Pharmacology, Peshawar Medical and Dental College, Peshawar
  • Nabiha Naeem Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
  • Dua-E-Jamila Khurrum Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan
  • Irfan Ullah Department of Life Sciences, School of Science, University of Management and Technology, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i6.583

Keywords:

Cardiovascular, Aspirin, Thromboxane, Myocardial Infarction, Stroke

Abstract

In a higher-risk group, we investigated if aspirin resistance, which is defined as inability to reduce production of thromboxane, enhanced the risk for cardiovascular disease. Methods: The Cardiac Outcome Preventive Assessment Study collected baseline urine samples from 5000 patients. A level of urinary 11-dehydro-thromboxane B2 was measured, which is a marker of within vitro cell generation of thromboxane, in 400 cured patients with aspirin having a cardiovascular death, stroke and infarction, stroke during a 5-year follow-up and in 400 age - and matching sex control subjects, which did not have an event, using a nested case-control design. Result: After accounting for baseline differences, the risks of infarction, strokes, or cardiac mortality rose with every fourth of 11-dihydro-thromboxane B2, with individuals in the top fourth section having a 1.9-fold greater threat than those from the lower portion (“OR, 1.9; 95% CI, 1.3 to 2.8; p=0.009). The upper quartile showed a 2-fold increased myocardial infarction risk ("OR, 2.1; 95% CI, 1.3 to 3.5; p=0.07) and a 3.6-fold elevated risk of cardiac death ("OR, 3.6; 95% CI, 1.78to 7.5; p=0.01) than the lower quartile. Conclusions: the 11-dehydro thromboxane B2   level in urine, better determine the risk of cardiovascular events or cardiovascular death in aspirin-treated patients. These findings also depicts that patients with elevated urine 11-dehydro thromboxane B2 concentrations are more impervious to aspirin, and could profit from greater antiplatelet medications or therapies that even more efficiently stop thromboxane generation in vivo or activities.

References

Wang N, Vendrov KC, Simmons BP, Schuck RN, Stouffer GA, Lee CR. Urinary 11-dehydro-thromboxane B2 levels are associated with vascular inflammation and prognosis in atherosclerotic cardiovascular disease. Prostaglandins & other lipid mediators. 2018 Jan; 134:24-31. doi: 10.1016/j.prostaglandins.2017.11.003.

Venketasubramanian N, Agustin SJ, Padilla JL, Yumul MP, Sum C, Lee SH et al. Comparison of Different Laboratory Tests to Identify "Aspirin Resistance" and Risk of Vascular Events among Ischaemic Stroke Patients: A Double-Blind Study Journal of Cardiovascular Development and Disease. 2022 May; 9(5):156. doi: 10.3390/jcdd9050156.

Sisodia P, Bhatia R. Aspirin resistance and stroke. Journal of Stroke Medicine. 2018 Jun; 1(1):19-27. doi.10.1177/2516608518777017

Chauhan S, Singh A, Karkala YR, Devasia T, Kareem H, Uppunda D et al. Gender-specific 11-dehydro-thromboxane B2 levels in acute coronary syndrome and its association with clinical outcomes. Journal of Applied Pharmaceutical Science. 2020 Nov; 10(11):010-7.

Ebrahimi P, Farhadi Z, Behzadifar M, Shabaninejad H, Abolghasem Gorji H, Taheri Mirghaed M et al. Prevalence rate of laboratory defined aspirin resistance in cardiovascular disease patients: A systematic review and meta-analysis. Caspian Journal of Internal Medicine. 2020; 11(2):124-134. doi: 10.22088/cjim.11.2.124..

Liu H, Xu Z, Sun C, Chen Q, Bao N, Chen W et al. Perioperative urinary thromboxane metabolites and outcome of coronary artery bypass grafting: a nested case-control study. BMJ Open. 2018 Aug; 8(8):e021219. doi: 10.1136/bmjopen-2017-021219

Block RC, Shearer GC, Holub A, Tu XM, Mousa S, Brenna JT et al. Aspirin and omega-3 fatty acid status interact in the prevention of cardiovascular diseases in Framingham Heart Study. Prostaglandins, Leukotrienes and Essential Fatty Acids. 2021 Jun;169:102283. doi: 10.1016/j.plefa.2021.102283

Noor M, Nawaz U, Fazal I, Waheed A. Aspirin resistance: An emerging threat to cardiovascular disease patients and its association with age and gender. Pakistan Heart Journal. 2018; 51(2).

Furtado RHM, Giugliano RP, Dalcoquio TF, Arantes FBB, Barbosa CJDG, Genestreti PRR et al. Increased bodyweight and inadequate response to aspirin in individuals with coronary artery disease. Journal of Thrombosis and Thrombolysis. 2019 Aug;48(2):217-224. doi: 10.1007/s11239-019-01830-z

Wang IE, Yi S, Block RC, Mousa SA. Aspirin and omega-3 polyunsaturated fatty acid use and their interaction in cardiovascular diseases and colorectal adenomas. Nutrition Research Reviews. 2021 Jul:1-13. doi: 10.1017/S0954422421000238.

Behera KG, Samal S, Swain J, Mohanty JN. Aspirin Resistance in Patients with Ischemic Stroke: Study at a Tertiary Care Teaching Hospital. Annals of the Romanian Society for Cell Biology. 2021 May: 14486-94.

McCarthy NS, Vangjeli C, Surendran P, Treumann A, Rooney C, Ho E, et al. Genetic variants in PPARGC1B and CNTN4 are associated with thromboxane A2 formation and with cardiovascular event free survival in the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). Atherosclerosis. 2018 Feb; 269:42-49. doi: 10.1016/j.atherosclerosis.2017.12.013.

Lim ST, Thijs V, Murphy SJX, Fernandez-Cadenas I, Montaner J, Offiah C, et al. Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis. Journal of Neurology. 2020 Oct; 267(10):3021-3037. doi: 10.1007/s00415-020-09932-y.

De Stefano V, Rocca B, Tosetto A, Soldati D, Petrucci G, Beggiato E, et al. The Aspirin Regimens in Essential Thrombocythemia (ARES) phase II randomized trial design: Implementation of the serum thromboxane B2 assay as an evaluation tool of different aspirin dosing regimens in the clinical setting. Blood Cancer Journal. 2018 Jun 1;8(6):49. doi: 10.1038/s41408-018-0078-3.

Alegbeleye BJ, Akpoveso OO, Mohammed RK, Asare BY. Pharmacology, pharmaceutics and clinical use of aspirin: a narrative review. Journal of Drug Delivery and Therapeutics. 2020 Oct; 10(5-s):236-53. /doi.10.22270/jddt.v10i5-s.4351

Rezabakhsh A, Soleimanpour HJFiCDR-A-AAV. Aspirin Desensitization/Challenge in Patients with Cardiovascular Diseases: Current Trends and Advances. 2022; 5:147. doi.o10.2174/9789815040616122050007

Gurbel PA, Bliden KP, Zhu J, Troullos E, Centofanti R, Jarvis S, et al. Thromboxane inhibition during concurrent therapy with low-dose aspirin and over-the-counter naproxen sodium. Journal of Thrombosis and Thrombolysis. 2018 Jan; 45(1):18-26. doi: 10.1007/s11239-017-1593-y.

Horyniecki M, Łącka-Gaździk B, Niewiadomska E, Mazur B, Śnit M, Łabuz-Roszak B. Prevalence of high on-treatment platelet reactivity in patients with chronic kidney disease treated with acetylsalicylic acid for stroke prevention. Pol Arch Intern Med. 2018 Nov; 128(11):667-676. doi: 10.20452/pamw.4349.

Patrono C. Aspirin. InPlatelets. Academic Press. 2019 Jan: 921-936. doi.10.1016/B978-0-12-813456-6.00050-3

Abu Subeih H. Aspirin for Optimising Pregnancy Outcome in Pregestational Diabetes The Ireland Study (Investigating the Role of Early Low-dose Aspirin in pre-existing Diabetes) (Doctoral dissertation, Royal College of Surgeons in Ireland). 2021 Jan.

Downloads

Published

2022-06-30
CITATION
DOI: 10.54393/pbmj.v5i6.583
Published: 2022-06-30

How to Cite

Rehman, E. ., Hasnain Ali Shah, S. ., Nabi, M. ., Subhan, Z. ., Zaman, S., Naeem, N. ., Khurrum, D.-E.-J., & Ullah, I. . (2022). High Risk of Cardiovascular Events in Patients, Biosynthesis of Aspirin-Resistant Thromboxane And The Risk Of Stroke, Myocardial Infarction Or Death: Biosynthesis of Aspirin-Resistant Thromboxane & Risk of Stroke. Pakistan BioMedical Journal, 5(6), 213–218. https://doi.org/10.54393/pbmj.v5i6.583

Issue

Section

Original Article

Plaudit

Most read articles by the same author(s)

<< < 1 2