Abstract
Aspirin is the cornerstone of treatment in patients with coronary artery disease. However, several studies investigating the in vitro response of platelets to the administration of aspirin showed this response to be variable, with some patients exhibiting non-responsiveness or resistance. Aspirin resistance may be categorised as either ‘laboratory’ or ‘clinical’. Laboratory aspirin resistance is defined as the failure of aspirin to inhibit the production of thromboxane A2 (TxA2) by platelets or to inhibit platelet activation that depends on TxA2 production. Clinical aspirin resistance is defined as the failure to prevent the occurrence of atherothrombotic ischaemic episodes in patients to whom it is administered. So far, there is no generally accepted method for the ex vivo evaluation of platelet activation or for assessing the degree of platelet activation following aspirin administration and data concerning the clinical impact of aspirin resistance are conflicting. For these reasons it is not possible to suggest specific guidelines for the treatment of patients who show high levels of platelet activation or a low level of platelet inhibition after treatment with aspirin. The aim of this review is to present data from laboratory and clinical studies that are related to resistance to aspirin, and to discuss the possible causes, the clinical significance, and the ways of managing such resistance at a clinical level.
Keywords: Aspirin, resistance, acetylsalicylic acid, platelets, antiplatelet medication
Current Pharmaceutical Design
Title: Aspirin Resistance in Cardiovascular Disease: Pathogenesis, Diagnosis and Clinical Impact
Volume: 15 Issue: 10
Author(s): Athanasios Papathanasiou, John Goudevenos and Alexandros D. Tselepis
Affiliation:
Keywords: Aspirin, resistance, acetylsalicylic acid, platelets, antiplatelet medication
Abstract: Aspirin is the cornerstone of treatment in patients with coronary artery disease. However, several studies investigating the in vitro response of platelets to the administration of aspirin showed this response to be variable, with some patients exhibiting non-responsiveness or resistance. Aspirin resistance may be categorised as either ‘laboratory’ or ‘clinical’. Laboratory aspirin resistance is defined as the failure of aspirin to inhibit the production of thromboxane A2 (TxA2) by platelets or to inhibit platelet activation that depends on TxA2 production. Clinical aspirin resistance is defined as the failure to prevent the occurrence of atherothrombotic ischaemic episodes in patients to whom it is administered. So far, there is no generally accepted method for the ex vivo evaluation of platelet activation or for assessing the degree of platelet activation following aspirin administration and data concerning the clinical impact of aspirin resistance are conflicting. For these reasons it is not possible to suggest specific guidelines for the treatment of patients who show high levels of platelet activation or a low level of platelet inhibition after treatment with aspirin. The aim of this review is to present data from laboratory and clinical studies that are related to resistance to aspirin, and to discuss the possible causes, the clinical significance, and the ways of managing such resistance at a clinical level.
Export Options
About this article
Cite this article as:
Papathanasiou Athanasios, Goudevenos John and Tselepis D. Alexandros, Aspirin Resistance in Cardiovascular Disease: Pathogenesis, Diagnosis and Clinical Impact, Current Pharmaceutical Design 2009; 15 (10) . https://dx.doi.org/10.2174/138161209787846964
DOI https://dx.doi.org/10.2174/138161209787846964 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Clinical Presentations and Diagnosis of Brucellosis
Recent Patents on Anti-Infective Drug Discovery Vaccines and Photodynamic Therapies for Oral Microbial-Related Diseases
Current Drug Metabolism Recent Advances in Natural Product-Based Anti-Biofilm Approaches to Control Infections
Mini-Reviews in Medicinal Chemistry Platelets as Potential Immunomodulators: Is There a Role for Platelet Toll-Like Receptors?
Current Immunology Reviews (Discontinued) The Role of Universal Stress Proteins in Bacterial Infections
Current Medicinal Chemistry Bergenin - A Biologically Active Scaffold: Nanotechnological Perspectives
Current Topics in Medicinal Chemistry Prevention of Bacterial Endocarditis
Cardiovascular & Hematological Disorders-Drug Targets Coarctation of the Aorta - An Evolution of Therapeutic Options
Current Cardiology Reviews Phytochemical Analysis and Antibacterial Action of Indian Traditional Medicinal Plants
Anti-Infective Agents Drugs in Pediatric Ischemic Stroke
Current Drug Targets Pharmacological Treatments for Obesity
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Antiplatelet Agents in Cardiology: A Report on Aspirin, Clopidogrel, Prasugrel, and Ticagrelor
Current Pharmaceutical Design Plant-Derived Products as Antibacterial and Antifungal Agents in Human Health Care
Current Medicinal Chemistry New Developments in Antimicrobial Use in Sepsis
Current Pharmaceutical Design A Review of Selected Adult Congenital Heart Diseases Encountered in Daily Practice
Current Cardiology Reviews Methadone and the Heart: What the Clinician Needs to Know
Current Drug Abuse Reviews Medicinal Use of Lincosamides and Microbial Resistance to Them
Anti-Infective Agents in Medicinal Chemistry Nanomaterials for Photohyperthermia: A Review
Current Pharmaceutical Design Catastrophic Antiphospholipid Syndrome: Lessons from the “CAPS Registry”
Current Rheumatology Reviews Computational Modelling of Catalytic Properties and Modified Substrates of Fungal β-N-Acetylhexosaminidases
Mini-Reviews in Organic Chemistry