title: A brief review on high on-aspirin residual platelet reactivity.
abstract: Although aspirin is effective in secondary prevention in coronary heart disease, new thromboembolic events in patients on aspirin are frequently seen. In trials on aspirin-treated patients, platelet function tests have revealed large variability in platelet aggregation. This phenomenon has been named aspirin resistance, aspirin non-responsiveness or high-on-aspirin residual platelet reactivity. The mechanism of aspirin antiplatelet effect is due to the inhibition of cyclooxygenase-1 enzyme in platelets. In some trials, almost all patients on aspirin have a very low level of serum thromboxane B2, indicating that the measured platelet reactivity in aspirin-treated patients might be due to platelet activation via other pathways, such as ADP or thrombin. The prevalence of real aspirin resistance seems to be very low, and probably the term "high-on-aspirin residual platelet reactivity" should be preferred to describe this phenomenon.
authors: Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevaal, Norway; Department of Medicine, Vestre Viken HF, Ringerike Hospital, Hønefoss, Norway. Electronic address: alfaage@online.no.
authors: A A
authors: AA
authors: Pettersen
authors: Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevaal, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: H
authors: H
authors: Arnesen
authors: Center for Clinical Heart Research, Department of Cardiology, Oslo University Hospital, Ullevaal, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
authors: I
authors: I
authors: Seljeflot
mesh_terms: D000818:Animals; D001241:Aspirin / Q000009:adverse effects / Q000494:pharmacology*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000097:blood / Q000139:chemically induced / Q000517:prevention & control; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D015539:Platelet Activation / Q000187:drug effects* / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects* / Q000502:physiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects / Q000494:pharmacology*; D010979:Platelet Function Tests / Q000379:methods
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Aspirin; Coronary artery disease; Cyclooxygenase; Platelet reactivity; Thromboxane