首页|Association of Thromboxane Generation With Survival in Aspirin Users and Nonusers
Association of Thromboxane Generation With Survival in Aspirin Users and Nonusers
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NSTL
Elsevier
? 2022 American College of Cardiology FoundationBackground: 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。
aspirinisoprostanemortalityplateletsthromboxane
Rade J.J.、Barton B.A.、Vasan R.S.、Kronsberg S.S.、Xanthakis V.、Keaney J.F.、Hamburg N.M.、Kakouros N.、Kickler T.A.
NSTL
Elsevier
