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The current and future landscape of urinary thromboxane testing to evaluate atherothrombotic risk

Sean-Xavier Neath, John L Jefferies, Jeffrey S Berger

  • 1Department of Emergency Medicine, University of California, San Diego, San Diego, CA; Advanced Heart Failure and Cardiomyopathy Services, Pediatric Cardiology and Adult Cardiovascular Diseases, and Division of Human Genetics, The Heart Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Medicine, and Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine, New York, NY; Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA; Health Diagnostic Laboratory, Richmond, VA; Boone Heart Institute, Denver, CO; Baylor Heart and Vascular Institute, Dallas, TX; Departments of Internal Medicine and Cardiology, Virginia Commonwealth University Health System, Richmond, VA, and Veterans Health Administration, Department of Veterans Affairs, Washington, DC; Department of Medicine, Division of Cardiovascular Medicine, University of California, San Diego and Director, Coronary Care Unit and Heart Failure Program, Veterans Affairs San Diego Healthcare System, San Diego, CA.

Reviews in Cardiovascular Medicine
|July 23, 2014
PubMed

Insights

Biomarker testing can assess aspirin effectiveness, ensuring proper dosing for patients. This helps prevent poor responses and improves outcomes for atherothrombotic diseases.

Area of Science:

  • Pharmacogenomics
  • Cardiovascular Medicine
  • Clinical Laboratory Science

Background:

  • Biomarker testing individualizes drug dosing based on genetic/environmental factors.
  • Aspirin is widely used for atherothrombotic disease prevention, yet suboptimal response is common.
  • Clinicians often lack awareness of the link between aspirin resistance and adverse clinical outcomes.

Purpose of the Study:

  • To review clinical and laboratory methods for assessing aspirin responsiveness.
  • To highlight the importance of whole-body thromboxane production measurement.
  • To emphasize routine biomarker testing for aspirin efficacy.

Main Methods:

  • Review of clinical literature on aspirin therapy and biomarker testing.
  • Discussion of laboratory techniques for measuring thromboxane production.
  • Analysis of factors influencing aspirin efficacy.

Main Results:

  • Suboptimal aspirin response is linked to inferior clinical outcomes.
  • Biomarker testing for aspirin efficacy is underutilized compared to other therapies.
  • Whole-body thromboxane production is a key indicator of aspirin responsiveness.

Conclusions:

  • Routine biomarker testing for aspirin efficacy is crucial for personalized medicine.
  • Measuring thromboxane production can guide aspirin dosing and improve patient outcomes.
  • Increased awareness and implementation of aspirin responsiveness testing are needed.

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