AspirinWorks; (11-Dehydro Thromboxane B2) Urine Test, Random

The AspirinWorks® Test was developed in conjunction with strategic partners. The test measures the biomarker of thromboxane, the chemical that makes platelets sticky.

A low level of the biomarker in the urine means that aspirin is working to reduce thromboxane production. High levels of the biomarker may mean that your dosage of aspirin is not effective for decreasing the risk of a heart attack or stroke, and it’s time for you and your doctor to consider increasing the dose or changing your treatment strategy.

Useful in assessing if a patient will derive benefit from aspirin therapy, determining an individual’s risk of coronary heart disease and stroke, and identifying the effectiveness of antiplatelet therapies.

Thromboxane B2 (TxB2) is the stable, inactive product of prostaglandin metabolism of thromboxane A2 which is renally cleared and, therefore, can be measured in the urine. Studies have shown that thromboxane B2 is a sensitive indicator of platelet activation. Since platelets participate in atherogenesis and contribute to acute, ischemic complications, elevated TxB2 levels may reflect ongoing cardiovascular, peripheral vascular, and cerebrovascular disease processes. TxB levels may also be of interest in conditions with increased platelet turnover, such as disseminated intravascular coagulation or immune thrombocytopenia. Studies of patients with diffuse atherosclerotic disease show that TxB2 may be a more sensitive measure of platelet activation than other platelet-specific proteins. Serum or plasma TxB2 assays are typically limited to a research setting because of the significant in vitro platelet instability.

Unlike platelet aggregation tests, which require freshly drawn blood that must be evaluated within at least four hours, the AspirinWorks Test is performed on a random urine sample. 

An increasing body of evidence in the medical literature overwhelmingly supports clinically significant variability in aspirin effect, which has been well-established in findings from recent trials, including the Heart Outcomes Prevention Evaluation (HOPE) Study and the CHARISMA trial. These trials have demonstrated that:

• Though resistance may not be the correct term to describe this phenomenon, not all patients receive the same protective benefits from low-dose aspirin therapy.
• Increased levels of urinary 11dhTxB2 are associated with as much as a four-fold increased risk for adverse cardiovascular events or death.
• Statin treatment is associated with lower concentrations of 11dhTxB2.
• 11dhTxB2 is an independent, modifiable predictor of risk for stroke, heart attack, and cardiac death.