Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans

Details

• Alternative Title:
  J Thromb Thrombolysis
• Personal Author:
  Infeld, Margaret ; Friede, Kevin A. ; San, Tan Ru ; Knickerbocker, Holly J. ; Ginsburg, Geoffrey S. ; Ortel, Thomas L. ; Voora, Deepak
• Description:
  Background:
  
  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.
  
  Methods:
  
  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.
  
  Results:
  
  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).
  
  Conclusions:
  
  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.
  
  
• Subjects:
  Adult Aged Aspirin Black Or African American Blood Platelets Dose-Response Relationship, Drug Female Humans Male Middle Aged Platelet Aggregation Platelet Aggregation Inhibitors Platelet Function Tests Ticagrelor Whites

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• Source:
  J Thromb Thrombolysis. 51(2):249-259
• Pubmed ID:
  33159252
• Pubmed Central ID:
  PMC7889728
• Document Type:
  Journal Article
• Funding:
  2012/0003R/Duke-National University Singapore/ ; 5RC1GM091083/National Institutes of General Medical Sciences/ ; R01 HL118049/HL/NHLBI NIH HHSUnited States/ ; U01 DD000014/DD/NCBDD CDC HHSUnited States/ ; 5U01DD000014/CC/CDC HHSUnited States/ ; RC1 GM091083/GM/NIGMS NIH HHSUnited States/ ; UL1 RR024128/RR/NCRR NIH HHSUnited States/ ; R01HL118049/Foundation for the National Institutes of Health/ ; 5UL1RR024128/RR/NCRR NIH HHSUnited States/
• Volume:
  51
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:e6943f920c3c07eb84ae33a967893ff6ff2f692277f0efd48c82607d19293c88
• Download URL:
  https://stacks.cdc.gov/view/cdc/103144/cdc_103144_DS1.pdf
• File Type:
  [PDF - 924.93 KB ]