Serum uric acid level negatively correlated with the prevalence of clopidogrel low response in patients undergoing antiplatelet treatment with aspirin and clopidogrel |
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| Affiliation: | 1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;2. Department of Cardiology, The Affiliated Huaian No.1 People''s Hospital of Nanjing Medical University, Huaian, China;3. Department of Cardiology, Taizhou People''s Hospital, Taizhou, China;1. Dipartimento di Farmacia, Università degli Studi di Napoli “Federico II”, Napoli, Italy;2. Fondazione Edmund Mach Research and Innovation Centre, Food Quality and Nutrition Department, S. Michele all'' Adige, Trento, Italy;3. Centro Cardiologico Monzino, IRCCS, Milano, Italy;4. Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy;5. Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy;1. Istanbul Education and Research Hospital, Department of Internal Medicine, Istanbul, Turkey;2. Istanbul Education and Research Hospital, Department of Cardiology, Istanbul, Turkey;1. Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China;2. Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, 450001, Henan, China;1. Ph. D. Program in Pharmacology and Toxicology, Department of Medicine, School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan;2. Division of Nephrology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97004, Taiwan;3. School of Medicine, Tzu Chi University, Hualien, 97004, Taiwan;4. Division of Cardiology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97004, Taiwan;5. National Agency of Drug and Food Control of Republic of Indonesia, Jakarta, 10560, Indonesia;6. Department of Pharmacology, Tzu Chi University, Hualien, 97004, Taiwan;7. CardioVascular Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, 97004, Taiwan;1. Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China;2. Tongzhou Maternal and Child Health Hospital of Beijing, 101101, China;3. Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China |
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| Abstract: | Background and aimsIt has been reported that elevated serum uric acid (SUA) is related to inflammation and potentially to platelet hyper-reactivity. However, the relationship between elevated SUA and residual platelet reactivity is uncertain in patients on dual antiplatelet treatment (DAPT) with aspirin and clopidogrel.Methods and resultsA cross-sectional cohort study was conducted on 2569 patients undergoing DAPT with aspirin and clopidogrel. Patients' SUA levels, residual platelet aggregation, routine blood tests and clinical characteristics were recorded. The relationship between SUA level and residual platelet aggregation was assessed by correlation analysis, and the relationship between SUA level and the prevalence of clopidogrel low response (CLR) was assessed by multivariate logistic regression analysis. Adenosine diphosphate (ADP) induced platelet aggregation (PLADP) was higher in normal-SUA group than that in hyperuricemia group [30(21, 40) % vs. 27(19, 39) %, p = 0.032]. No significant difference was found for arachidonic acid (AA) induced platelet aggregation (PLAA) between the two groups [4(2, 5) % vs. 3(2, 5) %, p = 0.557]. The correlation between SUA and PLADP was statistically significant(r = −0.115, p < 0.001), while that between SUA and PLAA was non-significant (r = −0.012, p = 0.643). Using the multivariate logistic regression analysis, higher SUA concentration was associated with a decreased risk of clopidogrel low response (CLR) (OR [95%CI] = 0.997 [0.995–0.999], p = 0.001).ConclusionThis is the largest study to date showing that in patients receiving DAPT with aspirin and clopidogrel, SUA is independently and negatively associated with the prevalence of clopidogrel low response.Clinical trial registrationURL: http://www.clinicaltrials.gov Unique Identifier: NCT01955200. |
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| Keywords: | Uric acid Platelet reactivity Clopidogrel low response |
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