Comparison between urinary 11-dehydrothromboxane B2 detection and platelet Light Transmission Aggregometry (LTA) assays for evaluating aspirin response in elderly patients with coronary artery disease

• Compared two methods to assess aspirin clinical efficacy in Chinese elderly population.
• Poor correlation and lack of agreement between the 2 tests were observed.
• LTA assay might be more efficient in predicting future risk of cardiovascular events.

Aspirin is widely used in the primary and secondary prevention of cardiovascular diseases. The aim of our study was to compare between two established methods of aspirin response, urinary 11-dehydrothromboxane B2 (11dhTXB2) and platelet Light Transmission Aggregometry (LTA) assays in elderly Chinese patients with coronary artery disease (CAD), and to investigate the clinical significance of both methods in predicting cardiovascular events. Urinary 11dhTxB2 assay and arachidonic acid-induced (AA, 0.5 mg/ml) platelet aggregation by Light Transmission Aggregometry (LTAAA) assay were measured to evaluate aspirin responses. High-on aspirin platelet reactivity (HAPR) was defined as urinary 11dhTxB2 > 1500 pg/mg or AA-induced platelet aggregation ≥ 15.22%—the upper quartile of our enrolled population. The two tests showed a poor correlation for aspirin inhibition (r = 0.063) and a poor agreement in classifying HAPR (kappa = 0.053). With a mean follow-up time of 12 months, cardiovascular events occurred more frequently in HAPR patients who were diagnosed by LTA assay as compared with no-HAPR patients (22.5% versus 10.6%, P = 0.039, OR = 2.45, 95% CI = 1.06–5.63). However, the HAPR status, as determined by urinary 11dTXB2 measurement, did not show a significant correlation with outcomes.