Aspirin antiplatelet effects are associated with body weight

• Published in: Vascular pharmacology Vol. 125-126; p. 106635
• Main Authors: Mourikis, Philipp, Zako, Saif, Dannenberg, Lisa, Helten, Carolin, Naguib, David, Hohlfeld, Thomas, Petzold, Tobias, Levkau, Bodo, Zeus, Tobias, Kelm, Malte, Polzin, Amin
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2020; Elsevier Science Ltd
• Subjects: Aggregometry; Aspirin; Body weight; Clinical trials; High on-treatment platelet reactivity; Ischemia; Obesity; Patients; Pharmacodynamics; Pharmacology; Platelets; AA; Aggregometry; Obesity; Aspirin; High on-treatment platelet reactivity; CAD; DM; Platelets; HTPR; AUC
• ISSN: 1537-1891; 1879-3649
• DOI: 10.1016/j.vph.2019.106635

Aspirin is indispensable in secondary prevention of ischemic events. Recently, it was reported that clinical aspirin effects are hampered in patients above 70 kg body weight. It is well known that a plethora of reasons beside obesity is associated with increased platelet reactivity and insufficient aspirin effects (HTPR). However, data regarding an association between pharmacodynamic response to aspirin and body weight are missing. In this pilot study, we included 59 patients from University Hospital Duesseldorf. Impedance aggregometry was used to assess pharmacodynamic response to aspirin. AA-induced platelet reactivity was significantly higher in patients above 70 kg (<70 kg: 28.27 ± 26.33 vs. >70 kg: 45.93 ± 27.1, p = .035) and correlated well with the bodyweight of patients in this study (r = 0.33, R2 = 0.09, p = .016). According to this, insufficient pharmacodynamic response (HTPR) to aspirin was significantly more frequent in patients over 70 kg (<70 kg: 25% vs. >70 kg: 43%, p = .035). Insufficient pharmacodynamic response to aspirin is associated with body weight. This finding may play a role in the impaired clinical efficacy of aspirin in patients >70 kg. An optimal aspirin regime in these patients needs to be evaluated in large scale trials. [Display omitted] What is already known about this subject?•Insufficient pharmacodynamic response to aspirin is associated with a higher risk for ischemic events.•Obesity influences pharmacodynamic and pharmacokinetic of aspirin.•Low-dose aspirin is only effective in patients <70 kg. What does this study add?•High on-treatment platelet reactivity is more frequent in patients over 70 kg.•Arachidonic acid-induced platelet aggregation correlates with the bodyweight. How might this impact on clinical practice?•Optimal antiplatelet therapy in patients over 70 kg is not known so far.•Higher doses of aspirin might improve platelet inhibition in patients over 70 kg.