Key result
Aspirin resistance is associated with an increased risk for adverse thrombotic events across various patient populations, including women and those with diabetes or heart failure.
Aspirin resistance is a clinically relevant phenomenon associated with increased adverse events, with disparities in prevalence among certain populations, though consensus on clinical management remains lacking.
Confirms aspirin resistance as a thrombotic risk marker in women and comorbidities; leaves open evidence-based testing or management strategies.
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.
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Airee et al. (2008) conducted a review in Vascular disease and aspirin resistance. Aspirin resistance was evaluated. Aspirin resistance is associated with an increased risk for adverse thrombotic events across various patient populations, including women and those with diabetes or heart failure.
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