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SpectraCell offers new Aspirin Response Testing service

SpectraCell Laboratories : 05 August, 2008  (Company News)
SpectraCell Laboratories is to offer a new Aspirin Response Testing (ART) service that measures a person's response to low-dose aspirin therapy, which is routinely prescribed to millions of Americans for cardiovascular disease prevention.
Recent research has shown that the effects of aspirin in reducing blood (platelet) ‘stickiness’ will vary considerably from patient to patient. In fact, conservative estimates suggest that aspirin resistance exists in about 25 percent of the population. Since studies show that individuals who do not respond to aspirin (in reducing platelet stickiness) are more than three times more likely to die from heart disease than those that respond well to aspirin, ART is vital information. Not only will ART tell a clinician if aspirin therapy is working, but it can also help a clinician determine the appropriate dosage of aspirin for each patient, allowing a doctor to tailor their recommendations to the individual.

Platelets are small blood cells that stick together to form blood clots and control bleeding. They produce a chemical called thromboxane to attract other platelets and increase their stickiness. Aspirin works by inhibiting the production of thromboxane by platelets, therefore reducing their stickiness and limiting the size of clots. ART measures the level of thromboxane production in apparently healthy individuals.

Specifically, ART is an enzyme-linked immunoassay (ELISA) that measures the levels of 11-Dehydro Thromboxane B2 (11dhTxB2) in human urine. It reflects in vivo production of thromboxane A2, which is the target of aspirin therapy. Clinical studies such as the large HOPE (Heart Outcomes Prevention Evaluation) study have shown that elevated levels of 11dhTxB2 correlate to increased cardiovascular risk.

'Over one million Americans will have a heart attack this year and 40 percent of those will be fatal. Many of these people are taking aspirin with the assumption that it has the same level of efficacy on everyone,' said Dr Fred Crawford, vice president of operations and technical director at SpectraCell Laboratories. 'Plus, most people assume aspirin is totally benign, which is not always the case. For the functionally minded physician, ART is a superb diagnostic tool for identifying asymptomatic patients whose aspirin treatment is not working.'

There are several reasons why a patient may not respond well to aspirin. It may be as simple as a patient taking a dose too low to effectively inhibit thromboxane A2 production. Platelets can also be activated by pathways that are not blocked by aspirin so other anti-thrombotic therapies may benefit patients that are resistant to aspirin for this reason.

Standard platelet function tests require freshly drawn blood and must be evaluated within four hours. However, since ART uses a random urine sample, it is not subject to variables associated with blood sampling. In addition, aspirin response is highly assay-specific, meaning that a patient may not test positive for aspirin resistance with tests that stimulate platelet aggregation in vitro via other, less specific pathways. ART is done in vivo and specifically measures stable thromboxane metabolites. The final results are reported in picograms of 11dhTxB2 per milligram of creatine to standardise results to urine concentration.
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