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Malondialdehyde Assay in the Evaluation of Aspirin Antiplatelet Effects

Amin Polzin1, Lisa Dannenberg2, Theresa Schneider2

  • 1Division of Cardiology, Pulmonology, and Vascular Medicine, Heinrich Heine University Medical Center Düsseldorf, Düsseldorf, Germanyamin.polzin@med.uni-duesseldorf.de.

Pharmacology
|October 26, 2018
PubMed

Insights

A new malondialdehyde (MDA) assay reliably detects high on-treatment platelet reactivity (HTPR) to aspirin, a common issue in cardiovascular prevention. This potential bedside test offers a simpler alternative to complex existing methods for assessing aspirin

Area of Science:

  • Cardiovascular Medicine
  • Clinical Chemistry
  • Pharmacology

Background:

  • Aspirin is crucial for secondary prevention in patients with myocardial infarction and coronary artery disease.
  • High on-treatment platelet reactivity (HTPR) to aspirin is frequent, leading to increased cardiovascular events.
  • Current assays for aspirin's antiplatelet effects are complex and require specialized laboratory expertise.

Purpose of the Study:

  • To develop and validate a novel, potentially bedside assay for determining aspirin's pharmacodynamic response.
  • To compare a new malondialdehyde (MDA) assay with conventional methods for assessing aspirin's antiplatelet effects.

Main Methods:

  • A fluorometric malondialdehyde (MDA) assay was developed and compared to thromboxane B2 (TX B2) enzyme-linked antibody assay and arachidonic acid-induced light transmission aggregometry (LTA).
  • Measurements were performed in 22 healthy individuals and 63 patients treated with aspirin.
  • Receiver operating characteristic (ROC) analysis was used to evaluate the MDA assay's ability to detect HTPR.

Main Results:

  • MDA levels showed strong correlations with TX formation (R = 0.81) and LTA (R = 0.84) in patients.
  • The MDA assay demonstrated high accuracy in detecting HTPR, with an area under the ROC curve of 0.965.
  • An optimal cut-off of > 128 nmol/L for the MDA assay yielded 100% sensitivity and 91% specificity for detecting HTPR.

Conclusions:

  • The new MDA assay is a reliable and specific method for detecting HTPR to aspirin.
  • This assay presents a promising, potentially simpler alternative to current complex laboratory methods.
  • Further evaluation of this potential bedside assay in clinical practice is warranted.

Keywords:
AspirinHigh on-treatment platelet reactivityMalondialdehyde

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