Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans.
Adult
Black or African American
Aged
Aspirin
/ pharmacology
Blood Platelets
/ drug effects
Dose-Response Relationship, Drug
Female
Humans
Male
Middle Aged
Platelet Aggregation
/ drug effects
Platelet Aggregation Inhibitors
/ pharmacology
Platelet Function Tests
Ticagrelor
/ pharmacology
White People
African-American
Aspirin
European-American
Light transmission aggregometry
Platelet reactivity
Ticagrelor
Journal
Journal of thrombosis and thrombolysis
ISSN: 1573-742X
Titre abrégé: J Thromb Thrombolysis
Pays: Netherlands
ID NLM: 9502018
Informations de publication
Date de publication:
Feb 2021
Feb 2021
Historique:
accepted:
30
10
2020
pubmed:
8
11
2020
medline:
26
10
2021
entrez:
7
11
2020
Statut:
ppublish
Résumé
Platelet gene polymorphisms are associated with variable on-treatment platelet reactivity and vary by race. Whether differences in platelet reactivity and aspirin or ticagrelor exist between African-American and European-Americans remains poorly understood. Biological samples from three prior prospective antiplatelet challenge studies at the Duke Clinical Research Unit were used to compare platelet reactivity between African-American and European-American subjects. Platelet reactivity at baseline, on-aspirin, on-ticagrelor, and the treatment effect of aspirin or ticagrelor were compared between groups using an adjusted mixed effects model. Compared with European-Americans (n = 282; 50% female; mean ± standard deviation age, 50 ± 16), African-Americans (n = 209; 67% female; age 48 ± 12) had lower baseline platelet reactivity with platelet function analyzer-100 (PFA-100) (p < 0.01) and with light transmission aggregometry (LTA) in response to arachidonic acid (AA), adenosine diphosphate (ADP), and epinephrine agonists (p < 0.05). African-Americans had lower platelet reactivity on aspirin in response to ADP, epinephrine, and collagen (p < 0.05) and on ticagrelor in response to AA, ADP, and collagen (p < 0.05). The treatment effect of aspirin was greater in European-Americans with an AA agonist (p = 0.002). Between-race differences with in vitro aspirin mirrored those seen in vivo. The treatment effect of ticagrelor was greater in European-Americans in response to ADP (p < 0.05) but with collagen, the treatment effect was greater for African-Americans (p < 0.05). Platelet reactivity was overall lower in African-Americans off-treatment, on aspirin, and on ticagrelor. European-Americans experienced greater platelet suppression on aspirin and on ticagrelor. The aspirin response difference in vivo and in vitro suggests a mechanism intrinsic to the platelet. Whether the absolute level of platelet reactivity or the degree of platelet suppression after treatment is more important for clinical outcomes is uncertain.
Identifiants
pubmed: 33159252
doi: 10.1007/s11239-020-02327-w
pii: 10.1007/s11239-020-02327-w
pmc: PMC7889728
mid: NIHMS1644827
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Ticagrelor
GLH0314RVC
Aspirin
R16CO5Y76E
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
249-259Subventions
Organisme : Duke-National University Singapore
ID : 2012/0003R
Organisme : National Institutes of General Medical Sciences
ID : 5RC1GM091083
Organisme : NHLBI NIH HHS
ID : R01 HL118049
Pays : United States
Organisme : NCBDD CDC HHS
ID : U01 DD000014
Pays : United States
Organisme : CDC HHS
ID : 5U01DD000014
Pays : United States
Organisme : NIGMS NIH HHS
ID : RC1 GM091083
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR024128
Pays : United States
Organisme : Foundation for the National Institutes of Health
ID : R01HL118049
Organisme : NCRR NIH HHS
ID : 5UL1RR024128
Pays : United States
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