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CLINICAL STUDY: CORONARY ARTERY DISEASE

Effects of low-dose aspirin on serum C-reactive protein and thromboxane B₂ concentrations: a placebo-controlled study using a highly sensitive C-reactive protein assay

Mark Feldman, MD^* , Ishwarlal Jialal, MD, Sridevi Devaraj, PhD and Byron Cryer, MD^*

^* Medical Service, Dallas Department of Veterans Affairs Medical Center, Dallas, Texas, USA
Department of Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA
Department of Pathology, University of Texas Southwestern Medical School, Dallas, Texas, USA

Manuscript received December 15, 2000; revised manuscript received February 16, 2001, accepted March 1, 2001.

Reprint requests and correspondence: Dr. Mark Feldman, Dallas Veterans Affairs Medical Center (111), 4500 South Lancaster Road, Dallas, Texas 75216
mark.feldman{at}med.va.gov

OBJECTIVES

We performed a placebo-controlled study to evaluate the effect of low-dose aspirin on serum C-reactive protein (CRP) levels.

BACKGROUND

Elevated circulating concentrations of CRP, an inflammatory marker, increase the risk of thrombotic cardiovascular diseases such as myocardial infarction (MI). Moreover, low-dose aspirin therapy has been reported to be more effective in preventing MI in men with higher CRP levels than it is in those with lower levels, raising the possibility that aspirin prevents thrombosis by reducing vascular inflammation. The effect of low-dose aspirin therapy on serum CRP levels in men has been addressed recently, but the results of the two studies conflict.

METHODS

Effects of aspirin (81 mg every day or 325, 81 or 40 mg every-third-day given for 31 days) on serum CRP, using a highly-sensitive assay, and on serum platelet-cyclo-oxygenase (COX)-1-derived thromboxane (Tx) B₂ concentrations were studied simultaneously in 57 healthy volunteers (30 men and 27 women).

RESULTS

Trough platelet COX-1-derived serum Tx B₂ concentrations decreased by 100% with daily aspirin and by 90%, 84% and 78% with 325, 81 and 40 mg aspirin every-third-day (p < 0.001). However, there were no significant changes in serum CRP levels from baseline with daily low-dose aspirin therapy, with any of the every-third-day aspirin regimens or with placebo treatment.

CONCLUSIONS

Low doses of aspirin that markedly inhibit platelet COX-1 activity, as manifested by a profound decline in platelet-derived serum Tx B₂ concentrations, have no detectable effect on serum CRP levels in healthy men and women.

Abbreviations and Acronyms   ASA = aspirin (acetylsalicylic acid)   BMI = body mass index   COX = cyclo-oxygenase   CRP = C-reactive protein   IL-6 = interleukin-6   MI = myocardial infarction   Tx = thromboxane

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