Duke team develops blood Dx to predict aspirin treatment success

Duke Medicine researchers came up with a new blood test that can predict which cardiac patients will best respond to aspirin therapy and those at greatest risk for heart attacks.

Aspirin has been in use for years to treat patients suffering from heart disease and stroke. Duke researchers term it as an "inexpensive blood thinner." And so the new test matters because it gives doctors a new tool to help pinpoint patients who will benefit most from aspirin treatment (not everyone does). Up until now, figuring out who will benefit most from aspirin has been a shot in the dark.

The Duke team pursued its study with two groups of health volunteers and a third consisting of cardiology patients with heart disease being treated on an outpatient basis. Clinicians gave the healthy patients 325 mg of aspirin a day for up to a month. Heart disease patients received a low dose as part of their ongoing regimen.

After patients took their aspirin, the team used RNA microarray profiling to determine whether the drug had any impact on RNA expression and platelet function. They discovered quite a bit: 60 co-expressed genes (the "aspirin response signature") that corresponded to insufficient platelet response to aspirin therapy. The same gene expression happened for healthy and heart disease patients alike. Researchers tried again with another group of patients who had cardiac catheterizations, determining that their test successfully spotted patients who had subsequent heart attacks or later died.

More work is needed to see if the test results can be replicated in larger, and different, patient populations. And it could take some time before the initial promising results translate to an every-day test that patients can rely on. But senior author Geoffrey Ginsburg said in a statement that his team is focusing on further, broader studies as well as ways to develop a standardized testing system.

"We give the same dose to all patients, but maybe some patients need a larger does of aspirin, or maybe they need to try a different therapy entirely," said Ginsburg, director of genomic medicine at Duke's Institute for Genome Sciences & Policy and executive director of the Center for Personalized Medicine. "We need better tools to monitor patients and adjust their care accordingly, and the findings from our study move us in that direction."

The work of Ginsburg and his team is detailed in the Journal of the American College of Cardiology online.

- read the release
- here' s the journal abstract

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