Association of Thromboxane Generation With Survival in Aspirin Users and Nonusers.
J Am Coll Cardiol
; 80(3): 233-250, 2022 07 19.
Article
em En
| MEDLINE
| ID: mdl-35660296
ABSTRACT
BACKGROUND:
Persistent systemic thromboxane generation, predominantly from nonplatelet sources, in aspirin (ASA) users with cardiovascular disease (CVD) is a mortality risk factor.OBJECTIVES:
This study sought to determine the mortality risk associated with systemic thromboxane generation in an unselected population irrespective of ASA use.METHODS:
Stable thromboxane B2 metabolites (TXB2-M) were measured by enzyme-linked immunosorbent assay in banked urine from 3,044 participants (mean age 66 ± 9 years, 53.8% women) in the Framingham Heart Study. The association of TXB2-M to survival over a median observation period of 11.9 years (IQR 10.6-12.7 years) was determined by multivariable modeling.RESULTS:
In 1,363 (44.8%) participants taking ASA at the index examination, median TXB2-M were lower than in ASA nonusers (1,147 pg/mg creatinine vs 4,179 pg/mg creatinine; P < 0.0001). TXB2-M were significantly associated with all-cause and cardiovascular mortality irrespective of ASA use (HR 1.96 and 2.41, respectively; P < 0.0001 for both) for TXB2-M in the highest quartile based on ASA use compared with lower quartiles, and remained significant after adjustment for mortality risk factors for similarly aged individuals (HR 1.49 and 1.82, respectively; P ≤ 0.005 for both). In 2,353 participants without CVD, TXB2-M were associated with cardiovascular mortality in ASA nonusers (adjusted HR 3.04; 95% CI 1.29-7.16) but not in ASA users, while ASA use was associated with all-cause mortality in those with low (adjusted HR 1.46; 95% CI 1.14-1.87) but not elevated TXB2-M.CONCLUSIONS:
Systemic thromboxane generation is an independent risk factor for all-cause and cardiovascular mortality irrespective of ASA use, and its measurement may be useful for therapy modification, particularly in those without CVD.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Cardiovasculares
/
Aspirina
Tipo de estudo:
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
J Am Coll Cardiol
Ano de publicação:
2022
Tipo de documento:
Article