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Impact of Calcium Channel Blockers on Aspirin Reactivity in Patients with Coronary Artery Disease

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Abstract

Purpose

Calcium channel blockers (CCBs) do not reduce the risk of initial or recurrent myocardial infarction (MI) in patients diagnosed with stable coronary artery disease (CAD). The aim of this current study was to evaluate the association between CCBs and aspirin resistance in patients with CAD.

Methods

Patients with stable CAD who were regularly taking aspirin (75–100 mg qd) for at least 1 month prior to enrollment in the study were included. The VerifyNow system was used for platelet function testing with high on-aspirin platelet reactivity (HAPR) defined as aspirin reaction units (ARU) >550. We compared patients treated with CCBs versus control group.

Results

Five hundred three patients with CAD were included in this study, and 88 were treated with CCBs. Mean age (67.9±9.7 in the CCB group vs. 66.5±11.4 in the control group), gender (77.3 male vs. 82.9%), rates of diabetes mellitus (34.7 vs. 36.9%), rates of CKD (23.5 vs. 23.5%), dyslipidemia (85.1 vs. 85.3%), and statin therapy (89.5 vs. 90.7%) were similar. The mean ARU was 465.4±70.0 for patients treated with CCBs versus 445.2±60.0 in controls (p=0.006). Similarly, 15.9% of CCB patients demonstrated HAPR compared to 7.0% (p=0.006). The administration of CCBs was independently associated with HAPR in a multivariate analysis (OR 1.72, 95% CI: 1.04–8.91, p=0.047) as well as in propensity score matched analysis (OR 1.56; CI: 1.22–1.93; p<0.001).

Conclusions

Usage of CCBs is positively correlated with aspirin resistance. These findings may suggest an adverse pharmacologic effect of CCBs among patients with stable CAD treated with aspirin.

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Data Availability

Original research data will be available upon request.

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Authors and Affiliations

  1. Cardiovascular Division, Rabin Medical Center, Beilinson Hospital, 39 Jabotinsky St, 4941492, Petah-Tikva, Israel

    Afek Kodesh, Dorit Leshem-Lev, Alejandro Solodky, Ran Kornowski & Leor Perl

  2. The “Sackler” Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Afek Kodesh, Dorit Leshem-Lev, Alejandro Solodky, Ran Kornowski & Leor Perl

  3. Department of Cardiology, Assuta Ashdod Medical Center and the Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Eli Lev

  4. Felsenstein Medical Research Center, Rabin Medical Center, Petah-Tikva, Israel

    Dorit Leshem-Lev, Ran Kornowski & Leor Perl

Authors
  1. Afek Kodesh
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  2. Eli Lev
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  3. Dorit Leshem-Lev
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  4. Alejandro Solodky
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  5. Ran Kornowski
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  6. Leor Perl
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection were performed by Afek Kodesh, Eli Lev, Alejandro Solodky, and Leor Perl. Data analysis was performed by Leor Perl. Figures were made by Leor Perl. The first draft of the manuscript was written by Afek Kodesh and Leor Perl, and all authors read and edited the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Leor Perl.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Kodesh, A., Lev, E., Leshem-Lev, D. et al. Impact of Calcium Channel Blockers on Aspirin Reactivity in Patients with Coronary Artery Disease. Cardiovasc Drugs Ther 36, 467–473 (2022). https://doi.org/10.1007/s10557-021-07295-8

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  • DOI: https://doi.org/10.1007/s10557-021-07295-8

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