Improving aspirin toxicity through precision medicine.

Sha'aban, A. ORCID: https://orcid.org/0000-0002-5491-9851, Zainal, H., Muhamad, A. S., Hammad, M. A. and Ibrahim, B. 2018. Improving aspirin toxicity through precision medicine. Value in Health 21 , S93-S93. 10.1016/j.jval.2018.09.550

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Abstract

Objectives Low Dose Aspirin (LDA) is the cornerstone of secondary prevention in Coronary Artery Disease (CAD). Despite its established efficacy, it has a prime limitation arising from its gastric toxicity. The reason why some patients develop clinically significant toxicities while others develop no or minor toxicities is yet to be demystified. This study aims at identifying biomarkers for Low Dose Aspirin (LDA)-induced gastric toxicity and efficacy in CAD patients, which may enable personalization of LDA therapy. Methods CAD patients attending the cardiac clinic of Hospital Pulau Pinang that satisfy the study inclusion criteria were recruited after informed consent. Blood samples of recruited patients were obtained at baseline(Pre) and after one month(Post) of initiating LDA therapy. For each patient, Complete blood count was ordered and the Pre- and Post-LDA serum were analyzed using Proton nuclear magnetic resonance (1H NMR) spectroscopy to identify the biomarkers that may distinguish between those with and without gastric toxicity. Results Thirty-eight percent (38%) of the 74 patients that meet up with the inclusion criteria had a history of gastric toxicity. Chi-square test indicated a significant difference between the means of those with and without gastric toxicity (P-value: 0.001). Multinomial logistic regression indicated Platelet count between 150-180x103/μL as a significant predictor of gastric toxicity to LDA (rs: 0.021, p-value: 0.004). Preliminary results of the 1H NMR pharmacometabolomic analysis show some metabolites that are potential biomarkers for LDA-induced gastric toxicity in CAD patients. Conclusions This study clearly demonstrates the gastric toxicity of LDA. Multivariate statistical analysis and validation to ascertain these discriminating metabolites that may be linked to the gastric toxicity is ongoing.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	Elsevier
ISSN:	1098-3015
Last Modified:	08 Sep 2022 09:15
URI:	https://orca.cardiff.ac.uk/id/eprint/151943

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