Atherothrombosis accounts for 52 per cent of all deaths worldwide. This disease manifests as cardiovascular disease, ischemic heart disease and cerebrovascular disease and in the year 2000 is estimated to have claimed around 56 million people worldwide. The Centers for Disease Control has computed that the probability at birth of eventually dying from major cardiovascular diseases (47 per cent) was much higher than the probability of dying from cancer (22 per cent).

Antithrombotic drugs such as aspirin and clopidogrel are prescribed to check atherothrombosis. The American Heart Association (AHA) has recommended the use of aspirin in patients suffering from artery diseases and a second antiplatelet medicine for those with uncontrolled chest pain called unstable angina. These drugs inhibit the formation of a chemical called thromboxane A2, which is responsible for making platelets sticky and promotes blood clotting. It has been observed that the most commonly used drug--aspirin--does not show its antithrombotic activity in some patients. In this set of patients the protective effects of aspirin are not exhibited.

Scientists at McMaster University have developed tests, which by detecting the levels of a metabolite of thromboxane in urine, can determine whether the patient is a responder or a nonresponder to aspirin therapy. This test would eliminate the guesswork and help physicians to quantify the amount of the metabolite involved in aspirin resistance. The currently used qualitative platelet function tests are subject to multiple interferences. This test would help physicians measure the patient's response to aspirin and can adjust the dose or recommend alternative platelet therapy if the patient is not responding to aspirin.

It is very important to identify patients having aspirin resistance as studies have shown that patients taking aspirin who had a high level of thromboxane in their urine had a 3.5 times higher risk of cardiovascular death than patients who had the lowest level. By detecting high levels of 11-dehydro thromboxane B2 in urine, patients can be segregated as responders and nonresponders. In the nonresponders an alternative antiplatelet therapy can be initiated, which can more effectively block thromboxane production. This technology can assess the patient's relative risk for heart attack by measuring the patient's aspirin resistance.

Corgenix Medical Corporation and AspirinWorks, a division of Creative Clinical concepts Inc. have entered into a license agreement with McMaster University for the development, manufacturing and marketing of this innovative diagnostic test. This agreement provides Corgenix and Creative Clinical Concepts exclusive rights to the proprietary technology owned by McMaster.

Details:

Jack Hirsh, Professor Emeritus, McMaster University,

711 Concession St., Hamilton Ontario L8V 1C3

Phone: 905-525-9140 Extn. 42600

Fax: 905-575-2646

E-mail: jhirsh@thrombosis.hhscr.org

URL: www.fhs.mcmaster.ca/medicine/

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