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Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans.

Publication ,  Journal Article
Infeld, M; Friede, KA; San, TR; Knickerbocker, HJ; Ginsburg, GS; Ortel, TL; Voora, D
Published in: J Thromb Thrombolysis
February 2021

Platelet gene polymorphisms are associated with variable on-treatment platelet reactivity and vary by race. Whether differences in platelet reactivity and aspirin or ticagrelor exist between African-American and European-Americans remains poorly understood. Biological samples from three prior prospective antiplatelet challenge studies at the Duke Clinical Research Unit were used to compare platelet reactivity between African-American and European-American subjects. Platelet reactivity at baseline, on-aspirin, on-ticagrelor, and the treatment effect of aspirin or ticagrelor were compared between groups using an adjusted mixed effects model. Compared with European-Americans (n = 282; 50% female; mean ± standard deviation age, 50 ± 16), African-Americans (n = 209; 67% female; age 48 ± 12) had lower baseline platelet reactivity with platelet function analyzer-100 (PFA-100) (p < 0.01) and with light transmission aggregometry (LTA) in response to arachidonic acid (AA), adenosine diphosphate (ADP), and epinephrine agonists (p < 0.05). African-Americans had lower platelet reactivity on aspirin in response to ADP, epinephrine, and collagen (p < 0.05) and on ticagrelor in response to AA, ADP, and collagen (p < 0.05). The treatment effect of aspirin was greater in European-Americans with an AA agonist (p = 0.002). Between-race differences with in vitro aspirin mirrored those seen in vivo. The treatment effect of ticagrelor was greater in European-Americans in response to ADP (p < 0.05) but with collagen, the treatment effect was greater for African-Americans (p < 0.05). Platelet reactivity was overall lower in African-Americans off-treatment, on aspirin, and on ticagrelor. European-Americans experienced greater platelet suppression on aspirin and on ticagrelor. The aspirin response difference in vivo and in vitro suggests a mechanism intrinsic to the platelet. Whether the absolute level of platelet reactivity or the degree of platelet suppression after treatment is more important for clinical outcomes is uncertain.

Duke Scholars

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

February 2021

Volume

51

Issue

2

Start / End Page

249 / 259

Location

Netherlands

Related Subject Headings

  • White People
  • Ticagrelor
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Platelet Aggregation
  • Middle Aged
  • Male
  • Humans
  • Female
  • Dose-Response Relationship, Drug
 

Citation

APA
Chicago
ICMJE
MLA
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Infeld, M., Friede, K. A., San, T. R., Knickerbocker, H. J., Ginsburg, G. S., Ortel, T. L., & Voora, D. (2021). Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans. J Thromb Thrombolysis, 51(2), 249–259. https://doi.org/10.1007/s11239-020-02327-w
Infeld, Margaret, Kevin A. Friede, Tan Ru San, Holly J. Knickerbocker, Geoffrey S. Ginsburg, Thomas L. Ortel, and Deepak Voora. “Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans.J Thromb Thrombolysis 51, no. 2 (February 2021): 249–59. https://doi.org/10.1007/s11239-020-02327-w.
Infeld M, Friede KA, San TR, Knickerbocker HJ, Ginsburg GS, Ortel TL, et al. Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans. J Thromb Thrombolysis. 2021 Feb;51(2):249–59.
Infeld, Margaret, et al. “Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans.J Thromb Thrombolysis, vol. 51, no. 2, Feb. 2021, pp. 249–59. Pubmed, doi:10.1007/s11239-020-02327-w.
Infeld M, Friede KA, San TR, Knickerbocker HJ, Ginsburg GS, Ortel TL, Voora D. Platelet reactivity in response to aspirin and ticagrelor in African-Americans and European-Americans. J Thromb Thrombolysis. 2021 Feb;51(2):249–259.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

February 2021

Volume

51

Issue

2

Start / End Page

249 / 259

Location

Netherlands

Related Subject Headings

  • White People
  • Ticagrelor
  • Platelet Function Tests
  • Platelet Aggregation Inhibitors
  • Platelet Aggregation
  • Middle Aged
  • Male
  • Humans
  • Female
  • Dose-Response Relationship, Drug