Potential Aspirin Resistance in Patients with Obstructive Sleep Apnea Syndrome

Abstract

Objective:Obstructive sleep apnea syndrome (OSAS) is a common disorder among the public and it is associated with many cardio-cerebrovascular consequences. Aspirin is used as the first line of treatment regarding such complications; however, >20% of the patients have drug resistance which causes ongoing vulnerability to vascular accidents. The objective of this study is the evaluation of potential aspirin resistance in drug naïve severe OSAS patients.Materials and Methods:Thirty patients with a diagnosis of severe OSAS and 30 age-matched non-OSAS controls enrolled in the study. Urine samples of both patients and controls were analyzed for 11-dehydrothromboxane B2 (11-DHTBXB2) levels and compared afterward. Pairwise comparisons were performed and a two-tailed p-value of <0.05 was considered statistically significant.Results:Biochemical analysis of the urine samples revealed an 11-DHTBXB2 level of 26.7 pg/dL for the patient group, whereas the relative value was 12.7 pg/dL for the control group (p=0.005). The significant increase in urinary 11-DHTBXB2 levels among patients was independent of sex, age, and body mass index.Conclusion:Patients with OSAS had higher levels of urine 11-DHTBXB2 levels, hence higher aspirin resistance than controls. Identification of aspirin resistance and prediction of potential unresponsiveness to first-line antiplatelet therapy is essential in OSAS to guide the primary or secondary prophylaxis in this population who have a marked propensity to vascular insult.

Keywords

• obstructive sleep apnea syndrome
• osas
• aspirin
• acetilsalyciclic acid
• resistance
• aspirin unresponsiveness
• cardiovascular morbidity