Abstract Number: PB1617
Meeting: ISTH 2020 Congress
Theme: Platelets and Megakaryocytes » Megakaryocytes and Thrombopoiesis
Background: An interindividual variability in response to aspirin (ASA) has been recognized. A faster recovery of platelet cyclooxygenase (COX)-1 activity during the 24-h dosing interval, possibly related to enhanced platelet turnover, may explain incomplete thromboxane (TX) inhibition in a fraction of ASA-treated subjects.
Aims: To characterize the determinants of less-than expected low-dose ASA-response in patients with or without type 2 diabetes mellitus (T2DM).
Methods: One-hundred patients with and 100 without T2DM in chronic treatment with low dose ASA (100 mg/day) for cardiovascular prevention were recruited. Blood sampling was performed at 10 and 24 hours after a witnessed ASA administration. Serum TXB2 (sTXB2) was measured at each time point, and the slope of sTXB2 during the 10-24 h dosing interval was calculated to characterize the kinetics of platelet COX-1 recovery and to stratify patients in sTXB2 tertiles. Plasma glycocalicin (GC) and glycocalicin index (GCI), indexes of platelet destruction, and plasma thrombopoietin (TPO), index of thrombopoiesis, were measured in patients in the first and third tertiles.
Results: Platelet count was significantly increased in the third vs first tertile only in T2DM patients (p=0.0310) (Figure 1). In the whole group and both in subjects with and without T2DM, GC was significantly lower (p< 0.0001, p< 0.0001 and p< 0.0004, respectively), and in all and T2DM TPO was significantly higher (p=0.004 and p=0.02 respectively) in the third vs first tertile (Figure 2).
GC correlated inversely with TPO (p=0.013) and sTXB2 slope (p< 0.000) in all patients; GCI correlated inversely with TPO (p=0.003), sTXB2 slope (p< 0.000), PLT count (p< 0.000), and PLT mass (p< 0.000).
Conclusions: We showed for the first time that a suboptimal response to ASA, as reflected by accelerated kinetics of COX-1 recovery, is associated with reduced platelet destruction and enhanced platelet production, the latter at least in T2DM patients.
To cite this abstract in AMA style:
Liani R, Simeone PG, Tripaldi R, Boccatonda A, D'Ardes D, Golato M, Ciotti S, Luongo M, Creato V, Pepe R, Santilli F. Role of Platelet Production/Destruction Imbalance on the Interindividual Variability in Aspirin Response in Diabetic and Non-diabetic Patients [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/role-of-platelet-production-destruction-imbalance-on-the-interindividual-variability-in-aspirin-response-in-diabetic-and-non-diabetic-patients/. Accessed April 17, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/role-of-platelet-production-destruction-imbalance-on-the-interindividual-variability-in-aspirin-response-in-diabetic-and-non-diabetic-patients/