Effect of aspirin treatment on abacavir-associated platelet hyperreactivity in HIV-infected patients.
Int J Cardiol
; 263: 118-124, 2018 07 15.
Article
en En
| MEDLINE
| ID: mdl-29685693
ABSTRACT
BACKGROUND:
Ischemic cardiovascular events are a relevant cause of morbidity and mortality in HIV-infected patients. Use of abacavir (ABC), a nucleoside analog reverse transcriptase inhibitor, has been associated with increased risk of myocardial infarction (MI) and with platelet hyperreactivity. We explored whether low-dose aspirin reduces in vivo platelet activation and platelet hyperreactivity induced by ABC in HIV-infected subjects. METHODS ANDRESULTS:
In a randomized, placebo-controlled, cross-over study forty HIV-infected patients with ABC-associated platelet hyperreactivity, defined by a score based on laboratory variables reflecting in vivo platelet activation and ex vivo platelet hyperresponsiveness, were randomized to aspirin 100â¯mg daily for 15â¯days with subsequent cross-over to placebo for additional 15â¯days or placebo for 15â¯days with subsequent cross-over to aspirin for further 15â¯days. In vivo and ex vivo platelet activation markers were measured at day 15 and 30. One group of healthy subjects, one of untreated HIV infected-patients and one treated without ABC, were studied concomitantly. Serum TxB2 and urinary 11-dehydro-TxB2 were decreased by aspirin in ABC-treated patients, but not as much as in healthy controls. Aspirin therapy reduced significantly platelet hyperreactivity (score from 9.3, 95% CIs 8.7 to 10.0, to 7.5, 6.9 to 8.0), however without bringing it back to the levels of healthy controls (score 4.6, 95% CIs 3.6 to 5.6).CONCLUSION:
Aspirin reduces ABC-induced in vivo platelet activation and platelet hyperreactivity in HIV-infected patients, however without normalizing them. Whether the observed reduction of platelet activation is sufficient to prevent cardiovascular events requires a prospective trial.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Inhibidores de Agregación Plaquetaria
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Didesoxinucleósidos
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Infecciones por VIH
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Activación Plaquetaria
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Aspirina
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Fármacos Anti-VIH
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Female
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Humans
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Male
Idioma:
En
Revista:
Int J Cardiol
Año:
2018
Tipo del documento:
Article
País de afiliación:
Italia