| Title: |
Impaired Clinical Efficacy of Aspirin in Hypoalbuminemic Patients With Diabetes Mellitus |
| Authors: |
Sciacqua A.; Andreozzi F.; Succurro E.; Pastori D.; Cammisotto V.; Armentaro G.; Mannino G. C.; Fiorentino T. V.; Pignatelli P.; Angiolillo D. J.; Sesti G.; Violi F. |
| Contributors: |
Sciacqua, A.; Andreozzi, F.; Succurro, E.; Pastori, D.; Cammisotto, V.; Armentaro, G.; Mannino, G. C.; Fiorentino, T. V.; Pignatelli, P.; Angiolillo, D. J.; Sesti, G.; Violi, F. |
| Publisher Information: |
Frontiers Media S.A.; AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND |
| Publication Year: |
2021 |
| Collection: |
Sapienza Università di Roma: CINECA IRIS |
| Subject Terms: |
albumin; aspirin; cardiovascular event; diabete; platelet; thromboxane |
| Description: |
Objective: To investigate the impact of albumin levels on the aspirin efficacy, since aspirin inhibits platelet aggregation (PA) by cyclooxygenase one irreversible acetylation that is less effective in patients with type 2 diabetes mellitus (T2DM). Patients and Methods: A total of 612 aspirin (100mg/day)-treated T2DM patients were followed-up for 54.4 ± 7.3months. The primary endpoint, a composite of cardiovascular events (CVEs) including CV death, myocardial infarction, ischemic stroke and coronary revascularization, was analysed according to baseline values of serum albumin (≥ or < 3.5g/dL). Serum thromboxane (Tx)B2 was also measured. Results: 250 (40.8%) patients had serum albumin < 3.5g/dL; these patients were overweight and had higher values of fibrinogen (p=0.009), high sensitivity C-reactive protein (p=0.001) and fasting plasma glucose (p < 0.0001) compared to those with albumin ≥ 3.5g/dL. During follow-up, 86 CVEs were recorded, 49 and 37 in patients with serum albumin < or ≥3.5g/dL, respectively (p=0.001). At multivariable Cox regression analysis, serum albumin < 3.5g/dL (hazard ratio [HR] 1.887, 95% confidence interval [CI] 1.136–3.135, p=0.014), age (HR 1.552 for every 10years, 95%CI 1.157–2.081, p=0.003), fasting plasma glucose (HR 1.063, 95%CI 1.022–1.105, p=0.002) and beta-blocker use (HR 0.440, 95%CI 0.270–0.717, p=0.001) were associated to CVEs. Serum TxB2 levels (n = 377) were 0.32 ± 0.12 and 0.24 ± 0.12ng/ml in patients with albumin < or ≥ 3.5g/dL, respectively (p < 0.001). Conclusion: In T2DM patients, the efficacy of aspirin varies according to albumin levels. Hypoalbuminemia associated with impaired TxB2 inhibition and an increased risk of long-term CVEs. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| Relation: |
info:eu-repo/semantics/altIdentifier/pmid/34239442; info:eu-repo/semantics/altIdentifier/wos/WOS:000669856000001; volume:12; firstpage:1; lastpage:8; numberofpages:8; journal:FRONTIERS IN PHARMACOLOGY; https://hdl.handle.net/11573/1561860 |
| DOI: |
10.3389/fphar.2021.695961 |
| Availability: |
https://hdl.handle.net/11573/1561860; https://doi.org/10.3389/fphar.2021.695961 |
| Rights: |
info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.FDF43668 |
| Database: |
BASE |