THE ASSOCIATION BETWEEN URINARY 11-DEHYDROTHROMBOXANE B2 AND LABORATORY PARAMETERS IN ASPIRIN-TREATED PATIENTS WITH CARDIORENAL SYNDROME

Abstract BACKGROUND AND AIMS Evaluation of urinary levels of the 11-dehydrothromboxane B2 is one of the methods for assessing platelet reactivity while taking aspirin. High levels of 11-dehydrothromboxane B2 in urine indicate continued thromboxane generation which is associated with an increased risk of atherothrombotic cardiovascular events. The present study aimed to evaluate the association between 11-dehydrothromboxane B2 in urine and laboratory parameters in aspirin-treated patients with the cardiorenal syndrome in subgroups from quartile with the highest and the lowest levels of thromboxane metabolite. METHOD A total of 82 patients with stable coronary artery disease (CAD) and CKD (stages 2–4) were included in the study. Urinary levels of 11-dehydrothromboxane B2 (a stable metabolite of thromboxane A2) were assessed using ELISA kit by Enzo Life Sciences (Switzerland). Statistical analysis was performed using the chi-squared test and Spearman's rank correlation coefficient. RESULTS In the subgroup of patients from the quartile with the highest levels of urinary 11-dehydrothromboxane B2, a history of ischemic stroke (P = 0.032) and a history of myocardial infarction (P = 0.048) were more common. There were significant correlations between urinary 11-dehydrothromboxane B2 and platelet count (rs = 0.457, P = 0.043), platelet crit (rs = 0.481, P = 0.037), pulmonary artery systolic pressure (rs = 0.847, P = 0.016) and left ventricular ejection fraction (rs = −0.719, P = 0.045) in the same subgroup of patients. In the subgroup of patients from the quartile with the lowest levels of 11-dehydrothromboxane B2 in urine statistically significant correlations between thromboxane metabolite and fasting plasma glucose (rs = 0.581, P = 0.007) and hematocrit (rs = 0.441, P = 0.003) were found. CONCLUSION Our study identified the relationships between the urinary concentration of 11-dehydrothromboxane B2 and laboratory and echocardiography parameters in aspirin-treated patients with cardiorenal syndrome. Accordingly, the received results represent the varying response to aspirin in patients with stable CAD and CKD. Additional research is needed to clarify the impact of platelet indices and the association between platelet reactivity while taking aspirin and pulmonary hypertension on behalf of the possibility of personalization of antiplatelet therapy.