Key result
Aspirin resistance may decrease the clinical benefit of antiplatelet therapy, requiring a combination of laboratory assays to confirm compliance and identify truly at-risk individuals.
A single laboratory assay is insufficient to diagnose aspirin resistance, highlighting the need for combined testing to confirm compliance and true platelet inhibition.
May prompt combined assays in select cases; leaves open impact on outcomes without randomized data.
Platelets play a crucial role in the pathogenesis of atherosclerosis, thrombosis, and stroke. Aspirin used alone or in combination with other antiplatelet drugs has been shown to offer significant benefit to patients at high risk of vascular events. Resistance to the action of aspirin may decrease this benefit. Aspirin resistance has been defined by clinical and/or laboratory criteria; however, detection by laboratory methods prior to experiencing a clinical event will likely provide the greatest opportunity for intervention. Numerous laboratory methods with different cutoff points have been used to evaluate the resistance. Noncompliance with aspirin treatment has also confounded studies. A single assay is currently insufficient to establish resistance. Combinations of results to confirm compliance and platelet inhibition may identify "at-risk" individuals who truly have aspirin resistance. The most effective strategy for managing patients with aspirin resistance is unknown; however, studies are currently underway to address this issue.
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Divani et al. (2012) conducted a review in Aspirin resistance. Aspirin was evaluated. Aspirin resistance may decrease the clinical benefit of antiplatelet therapy, requiring a combination of laboratory assays to confirm compliance and identify truly at-risk individuals.
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