PMID- 34239442
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20210710
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 12
DP  - 2021
TI  - Impaired Clinical Efficacy of Aspirin in Hypoalbuminemic Patients With Diabetes 
      Mellitus.
PG  - 695961
LID - 10.3389/fphar.2021.695961 [doi]
LID - 695961
AB  - 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 
      (100 mg/day)-treated T2DM patients were followed-up for 54.4 +/- 7.3 months. 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 < 3.5 g/dL). Serum 
      thromboxane (Tx)B(2) was also measured. Results: 250 (40.8%) patients had serum 
      albumin < 3.5 g/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 >/= 3.5 g/dL. 
      During follow-up, 86 CVEs were recorded, 49 and 37 in patients with serum albumin 
      < or >/=3.5 g/dL, respectively (p = 0.001). At multivariable Cox regression 
      analysis, serum albumin < 3.5 g/dL (hazard ratio [HR] 1.887, 95% confidence 
      interval [CI] 1.136-3.135, p = 0.014), age (HR 1.552 for every 10 years, 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 TxB(2) levels (n = 377) were 0.32 +/- 0.12 and 0.24 +/- 
      0.12 ng/ml in patients with albumin < or >/= 3.5 g/dL, respectively (p < 0.001). 
      Conclusion: In T2DM patients, the efficacy of aspirin varies according to albumin 
      levels. Hypoalbuminemia associated with impaired TxB(2) inhibition and an 
      increased risk of long-term CVEs.
CI  - Copyright (c) 2021 Sciacqua, Andreozzi, Succurro, Pastori, Cammisotto, Armentaro, 
      Mannino, Fiorentino, Pignatelli, Angiolillo, Sesti and Violi.
FAU - Sciacqua, Angela
AU  - Sciacqua A
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Andreozzi, Francesco
AU  - Andreozzi F
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Succurro, Elena
AU  - Succurro E
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Pastori, Daniele
AU  - Pastori D
AD  - Department of Clinical, Internal, Anaesthesiological, and Cardiovascular 
      Sciences, Sapienza University of Rome, Rome, Italy.
FAU - Cammisotto, Vittoria
AU  - Cammisotto V
AD  - Department of General Surgery and Surgical Specialty Paride Stefanini, Sapienza 
      University of Rome, Rome, Italy.
FAU - Armentaro, Giuseppe
AU  - Armentaro G
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Mannino, Gaia C
AU  - Mannino GC
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Fiorentino, Teresa Vanessa
AU  - Fiorentino TV
AD  - Department of Medical and Surgical Sciences, University Magna Graecia of 
      Catanzaro, Catanzaro, Italy.
FAU - Pignatelli, Pasquale
AU  - Pignatelli P
AD  - Department of Clinical, Internal, Anaesthesiological, and Cardiovascular 
      Sciences, Sapienza University of Rome, Rome, Italy.
AD  - Mediterranea Cardiocentro, Napoli, Italy.
FAU - Angiolillo, Dominick J
AU  - Angiolillo DJ
AD  - Division of Cardiology, University of Florida College of Medicine, Jacksonville, 
      FL, United States.
FAU - Sesti, Giorgio
AU  - Sesti G
AD  - Department of Clinical and Molecular Medicine, Sapienza, University of Rome, 
      Rome, Italy.
FAU - Violi, Francesco
AU  - Violi F
AD  - Department of Clinical, Internal, Anaesthesiological, and Cardiovascular 
      Sciences, Sapienza University of Rome, Rome, Italy.
AD  - Mediterranea Cardiocentro, Napoli, Italy.
LA  - eng
PT  - Journal Article
DEP - 20210622
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC8258313
OTO - NOTNLM
OT  - albumin
OT  - aspirin
OT  - cardiovascular events
OT  - diabetes
OT  - platelet
OT  - thromboxane
COIS- FV declares that he has received consulting fees from Bayer and Shionogi. DA 
      declares that he has received consulting fees or honoraria from Abbott, Amgen, 
      Aralez, AstraZeneca, Bayer, Biosensors, Boehringer Ingelheim, Bristol-Myers 
      Squibb, Chiesi, Daiichi-Sankyo, Eli Lilly, Haemonetics, Janssen, Merck, PhaseBio, 
      PLx Pharma, Pfizer, Sanofi, and The Medicines Company and has received payments 
      for participation in review activities from CeloNova and St Jude Medical. DA also 
      declares that his institution has received research grants from Amgen, 
      AstraZeneca, Bayer, Biosensors, CeloNova, CSL Behring, Daiichi-Sankyo, Eisai, Eli 
      Lilly, Gilead, Idorsia, Janssen, Matsutani Chemical Industry Co., Merck, 
      Novartis, Osprey Medical, Renal Guard Solutions, and the Scott R. MacKenzie 
      Foundation. GS declares that has received speaker/consulting honoraria from Novo 
      Nordisk, Eli Lilly, AstraZeneca, Boehringer Ingelheim, Merck Sharp andamp; Dohme 
      (MSD), Sanofi, Novartis, Sobi, Daiichi Sankyo, Theras, L-Nutra, Mundipharma, 
      Omikron, and Servier. PP declares that has received speaker/consulting honoraria 
      from Boehringer Ingelheim, Daiichi Sankyo, Pfizer, BMS, Bayer. The remaining 
      authors declare that the research was conducted in the absence of any commercial 
      or financial relationships that could be construed as a potential conflict of 
      interest.
EDAT- 2021/07/10 06:00
MHDA- 2021/07/10 06:01
PMCR- 2021/06/22
CRDT- 2021/07/09 06:55
PHST- 2021/04/29 00:00 [received]
PHST- 2021/06/07 00:00 [accepted]
PHST- 2021/07/09 06:55 [entrez]
PHST- 2021/07/10 06:00 [pubmed]
PHST- 2021/07/10 06:01 [medline]
PHST- 2021/06/22 00:00 [pmc-release]
AID - 695961 [pii]
AID - 10.3389/fphar.2021.695961 [doi]
PST - epublish
SO  - Front Pharmacol. 2021 Jun 22;12:695961. doi: 10.3389/fphar.2021.695961. 
      eCollection 2021.