Aspirin resistance affects one in four patients with vascular disease and is associated with an almost four-fold increased risk of major adverse limb and cardiovascular events.
Aspirin resistance affects approximately 25% of patients with vascular disease, significantly increasing their risk for adverse events and highlighting the need for validated point-of-care testing and alternative antithrombotic strategies.
Aspirin resistance describes a phenomenon where patients receiving aspirin therapy do not respond favorably to treatment, and is categorized by continued incidence of adverse cardiovascular events and/or the lack of reduced platelet reactivity. Studies demonstrate that one in four patients with vascular disease are resistant to aspirin therapy, placing them at an almost four-fold increased risk of major adverse limb and adverse cardiovascular events. Despite the increased cardiovascular risk incurred by aspirin resistant patients, strategies to diagnose or overcome this resistance are yet to be clinically validated and integrated. Currently, five unique laboratory assays have shown promise for aspirin resistance testing: Light transmission aggregometry, Platelet Function Analyzer-100, Thromboelastography, Verify Now, and Platelet Works. Newer antiplatelet therapies such as Plavix and Ticagrelor have been tested as an alternative to overcome aspirin resistance (used both in combination with aspirin and alone) but have not proven to be superior to aspirin alone. A recent breakthrough discovery has demonstrated that rivaroxaban, an anticoagulant which functions by inhibiting active Factor X when taken in combination with aspirin, improves outcomes in patients with vascular disease. Current studies are determining how this new regime may benefit those who are considered aspirin resistant.
Khan et al. (Mon,) conducted a review in Vascular disease. Aspirin resistance was evaluated. Aspirin resistance affects one in four patients with vascular disease and is associated with an almost four-fold increased risk of major adverse limb and cardiovascular events.