{"doi":"10.1016/j.bvth.2025.100085","title":"Platelet protease-activated receptor 4 genotype and response to aspirin in pregnancy","abstract":"Platelet protease activated receptor-4 (PAR4) Thr-120 allele is an activating allele associated with reduced aspirin response in-vitro. Aspirin is recommended in high-risk pregnancies to prevent preeclampsia and preterm birth. Evaluate the impact of PAR4 genotype on aspirin response in pregnancy, measured by Platelet Function Assay epinephrine closure time (PFA-100), and perinatal outcomes. Prospective cohort study of high-risk pregnancies taking 81mg aspirin daily. PFA-100 was assessed at baseline, 2-4 weeks after aspirin initiation (follow up-1) and at 28-32 weeks gestation (follow up-2). Primary outcome was difference in PFA-100 by genotype. Exposure defined as PAR4 Thr-120 homozygous vs not. 122 participants were included, 24 (19.6%) were PAR-4 Thr120 homozygous, and 106 completed follow up-1 with >75% adherence. Participants homozygous for PAR4 Thr-120 had a significantly higher rate of prior preterm birth (50.0% vs 16.1%, p=0.004). Genotype was not significantly associated with PFA-100 response in multivariable regression. In subset N=18 with urinary thromboxane data available, there was higher thromboxane levels in those homozygous vs not (geometric mean ratio 208 (1.66-2.61), p<.001in multi variable regression. There was a higher rate of placental intervillous thrombosis, not statistically significant (16.7% vs 3.9%, p=0.08). Patients homozygous for PAR-4 Thr120 had higher incidence of prior preterm birth, a risk factor for poor perinatal outcome. Aspirin response, measured by PFA-100, was similar across genotypes, although Thr120 homozygosity may be associated with reduced thromboxane suppression and a higher rate of placental vasculopathy even with 81mg aspirin daily.","journal":"Blood Vessels Thrombosis & Hemostasis","year":2025,"id":536330,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.961,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":675559,"name":"James V. Michael","orcid":"0000-0001-8796-5259","position":1,"is_corresponding":false},{"id":1421158,"name":"Antonios Tawk","orcid":"0000-0002-5668-7310","position":2,"is_corresponding":false},{"id":332573,"name":"Tingting Zhan","orcid":"0000-0001-9971-4844","position":3,"is_corresponding":false},{"id":426822,"name":"Joanna Chan","orcid":"0000-0002-0371-1786","position":4,"is_corresponding":false},{"id":63814,"name":"Walter K. Kraft","orcid":"0000-0002-5074-0141","position":5,"is_corresponding":false},{"id":492802,"name":"Steven E. McKenzie","orcid":"0000-0003-2654-8560","position":6,"is_corresponding":false},{"id":350785,"name":"Rupsa C. Boelig","orcid":"0000-0002-3705-6943","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:52:05.227140Z","pmid":"40918740","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}