Predictors of Aspirin Failure in Preeclampsia Prevention
Genetic, Laboratory and Clinical Factors Associated With Low-dose Aspirin Failure in the Prevention of Preeclampsia- An Exploratory Protocol
Rockefeller University
130 participants
Apr 13, 2023
INTERVENTIONAL
Conditions
Summary
Hypertensive disorders of pregnancy (including preeclampsia) are among the leading causes of pregnancy complications and maternal deaths worldwide. They also increase the risks to the babies. Numerous interventions have been suggested in order to reduce the rate of preeclampsia. Low-dose aspirin is the most beneficial prophylactic approach in this regard. Nevertheless, aspirin failure is not uncommon. The genetic, laboratory, and clinical factors associated with low-dose aspirin failure in the prevention of preeclampsia are largely unknown. The presence of a genetic variant in PAR4 receptor expressed on platelets, is associated with increased platelet function and possibly with aspirin failure.
Eligibility
Inclusion Criteria5
- Women aged 18-45 years with prior history of preeclampsia who received low dose aspirin in their subsequent gestation and either did or did not have a recurrence of preeclampsia.
- Aspirin was given in their subsequent pregnancy in a 81 mg dose prior to 16 weeks of gestation, and was taken with a self-reported compliance rate of at least 80%
- Subsequent pregnancy lasted beyond 20 weeks of gestation
- Willingness to abstain from non-prescription non-steroidal anti-inflammatory drugs (NSAIDs), which are known to interfere with platelet function assays, for one week prior to platelet function analyses.
- Healthy controls recruited for SNP assay optimization:
Exclusion Criteria14
- Age <18 years or >45 years
- Any clinically significant adverse reaction to aspirin on prior exposure
- Known bleeding disorder based on personal or family history
- History of kidney or liver impairment
- Current pregnancy
- Current use of antithrombotic agents (e.g., aspirin, clopidogrel, warfarin, direct acting oral anticoagulants).
- Chronic hypertension (systolic blood pressure >140 mmHG or diastolic pressure >90 mmHG, or use of antihypertensive drugs or diagnosis made by clinician)
- Diabetes mellitus
- Current known malignancy
- History of hemorrhagic stroke
- Participants may be excluded at the discretion of the investigator for medical, psychological or other reasons
- Rockefeller students, and Rockefeller employees in the Coller lab, are excluded from participation.
- Healthy controls:
- A. <18 years of age. B. Participants may be excluded at the discretion of the investigator for medical, psychological or other reasons C. Rockefeller students, and Rockefeller employees in the Coller lab, are excluded from participation.
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Interventions
Platelet assays including VerifyNow Aspirin assay, VerifyNow Base assay, platelet aggregometry, Thromboxana A2 levels- will be measured at baseline and 1 hour after administration of single-dose enteric-coated 81 mg aspirin
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT05709483