Aspirin resistance: a growing concern.

Chow, Sheryl L.; Cheung, Rebecca J.

Aspirin is the cornerstone of therapy in the treatment and prevention of cardiovascular disease. The potential benefit of aspirin therapy may be significantly reduced in patients with aspirin resistance, creating a clinical and economic burden on the healthcare system. The purpose of this article is to clarify the term ‘aspirin resistance’ describe the proposed mechanisms, review the clinical outcome studies with associated resistance testing, and discuss the potential pharmacologic management of this problem. Literature searches were performed using MEDLINE (January 1966 to January 2006) for review articles on aspirin resistance and antiplatelet activity. Aspirin's primary mechanism of action is to irreversibly inhibit cyclooxygenase-1 (COX-1); however, there are reports of alternative biochemical pathways producing platelet aggregation. The addition of thienopyridines to aspirin should be considered for the management of aspirin-resistant patients.

ASPIRIN; CARDIOVASCULAR disease treatment; DRUG resistance; BLOOD platelet aggregation; CYCLOOXYGENASES; PHARMACOLOGY

Formulary, 2006, Vol 41, Issue 4, p192

1082-801X

Academic Journal