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Effect of obesity on platelet reactivity and response to low-dose aspirin

Bryan C Bordeaux1, Rehan Qayyum, Lisa R Yanek

  • 1Department of Population Medicine, Harvard Medical School, Boston, MA, USA.

Preventive Cardiology
|April 10, 2010
PubMed

Insights

Obese individuals exhibit higher platelet reactivity, even after aspirin therapy. This suggests obesity may lead to reduced aspirin effectiveness in preventing cardiovascular events.

Area of Science:

  • Cardiology
  • Hematology
  • Metabolic Disorders

Background:

  • Aspirin is a cornerstone in preventing cardiovascular events.
  • Insufficient platelet function suppression by aspirin is linked to adverse outcomes.
  • Obesity is a growing public health concern with known cardiovascular risks.

Purpose of the Study:

  • To investigate the impact of obesity on platelet responsiveness to aspirin.
  • To determine if obesity influences aspirin resistance in high-risk patients.

Main Methods:

  • Prospective study involving 2014 participants.
  • Assessment of platelet reactivity via aggregometry and urinary thromboxane metabolite excretion.
  • Measurements taken before and after a 2-week course of low-dose aspirin (81 mg/d).

Main Results:

  • Obese individuals demonstrated significantly higher baseline platelet reactivity compared to nonobese individuals.
  • After aspirin therapy, obese individuals showed greater residual platelet aggregation in response to arachidonic acid (AA) and higher urinary 11-dehydro-thromboxane B2 (Tx-M) excretion.
  • Aspirin resistance was also significantly higher in the obese group (26.5% vs. 20.5%).

Conclusions:

  • Obesity is associated with increased native platelet reactivity.
  • Obese individuals retain greater platelet reactivity even after standard aspirin treatment, suggesting potential aspirin resistance.
  • These findings highlight a potential mechanism linking obesity to increased cardiovascular event risk in patients treated with aspirin.

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