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Aspirin Resistance Affects Cardiovascular Disease

Benefits of aspirin clear for secondary prevention of vascular disease

TUESDAY, May 6 (HealthDay News) -- Although aspirin has clear benefits for the secondary prevention of vascular disease, some patients may experience aspirin resistance, which has implications for the treatment of conditions associated with cardiovascular disease such as diabetes, according to a report in the May 13 issue of the Journal of the American College of Cardiology.

Armen Yuri Gasparyan, M.D., Ph.D., and colleagues from City Hospital in Birmingham, United Kingdom, reviewed the published literature and databases for clinical trials examining aspirin use.

The researchers note that trials examining aspirin for the primary prevention of vascular disease have shown mixed results. However, most studies have shown that aspirin is very effective for secondary prevention after acute myocardial infarction, for example. They also note that between 5.5 percent and 60 percent of patients exhibit aspirin resistance and do not respond adequately to aspirin therapy. Few quality trials have investigated this phenomenon with aspirin at standard doses, and the causes can include patient non-compliance, aspirin dosage, drug-drug interactions and increased platelet turnover. In addition, aspirin resistance can have important implications for the treatment of various cardiovascular disease states, such as diabetes mellitus, hypertension and heart failure.

"Until further studies are available to investigate aspirin resistance in more depth, a balanced approach is required when assessing patients for antiplatelet therapy," Gasparyan and colleagues conclude. "Certainly, co-morbidities that may enhance aspirin resistance (e.g., diabetes mellitus, hypertension, heart failure, inflammatory disorders, and so on) should be actively sought, as this may aid the practicing clinician in deciding between monotherapy with aspirin or co-prescription with other more potent antiplatelet drugs."

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