Aspirin resistance: An evaluation of current evidence and measurement methods

Christopher P. Martin, Robert L. Talbert

Research output: Contribution to journalReview article

35 Scopus citations

Abstract

Aspirin resistance is a poorly characterized phenomenon, whereby certain patients do not benefit from the antithrombotic effect of aspirin. The frequency of aspirin resistance is unknown, but estimates range from 5-60%. The mechanism of aspirin resistance also is unknown; proposed mechanisms are poor patient compliance, poor aspirin absorption, increased isoprostane activity, platelet hypersensitivity to agonists, increased cyclooxygenase-2 activity, a cyclooxygenase-1 polymorphism, and the platelet alloantigen 2 polymorphism of platelet glycoprotein IIIa. Aspirin resistance appears to be dose related in some patients and therefore may be overcome with high doses. Evidence indicates that aspirin resistance is a dynamic state, with significant intrapatient variability in aspirin sensitivity with time. To date, a sensitive and specific assay of aspirin effect that reliably predicts treatment failure has not emerged. However, several commercially available products are being marketed for this purpose without convincing clinical data. Despite a wealth of literature on the topic, aspirin resistance remains an enigma. Further investigation is needed regarding strategies to identify and treat patients resistant to aspirin.

Original languageEnglish (US)
Pages (from-to)942-953
Number of pages12
JournalPharmacotherapy
Volume25
Issue number7
DOIs
StatePublished - Jul 1 2005

Keywords

  • Antithrombotic effect
  • Aspirin monitoring
  • Aspirin resistance
  • Platelet function
  • Platelet polymorphisms

ASJC Scopus subject areas

  • Pharmacology (medical)

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