Aspirin resistance: disparities and clinical implications.
Abstract Aspirin is one of the most widely prescribed drugs for the prevention of thrombosis in patients with vascular disease. Yet, aspirin is unable to prevent thrombosis in all patients. The term "aspirin resistance" has been used to broadly define the failure of aspirin to prevent a thrombotic event. Whether this is directly related to aspirin itself through biochemical aspirin resistance or treatment failure, or if it is because of aspirin's inability to overcome the thrombogenic aspects of the disease process itself, has not been elucidated. This can have dramatic clinical implications for a variety of vascular disease subsets and is cause for concern, considering the high prevalence of aspirin use for both primary and secondary prevention. Disparities exist in the rates of aspirin resistance among certain patient populations, such as women, patients with diabetes mellitus, and those with heart failure, and across clinical conditions, such as cardiovascular and cerebrovascular disease. Clinical trial data from studies observing resistance have revealed that regardless of study size, dose of aspirin, control for drug interactions and adherence, or assay used to measure platelet function, aspirin resistance is associated with an increased risk for adverse events. Although the evidence is mounting, there has yet to be a consensus on the appropriate clinical response to aspirin resistance.
Airee
Anita
A
University of Tennessee College of Pharmacy, Knoxville Campus, 1924 Alcoa Highway, Knoxville, TN 37920, USA. aairee@utmem.edu
Draper
Heather M
HM
Finks
Shannon W
SW
D015906:Angioplasty, Balloon, Coronary; D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects / Q000502:physiology; D001026:Coronary Artery Bypass; D003920:Diabetes Mellitus / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D004351:Drug Resistance; D005260:Female; D006333:Heart Failure / Q000097:blood; D006801:Humans; D008297:Male; D055118:Medication Adherence; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017211:Treatment Failure
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin