, Volume 3, Issue 3, pp 197-200
Date: 25 Jun 2008

Aspirin in asymptomatic patients with confirmed positivity of antiphospholipid antibodies? No

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The antiphospholipid syndrome (APS) is an autoimmune disorder characterized by: (1) the presence of autoantibodies directed against protein/phospholipid complexes (aPL), including lupus anticoagulant (LA), anticardiolipin and anti-beta2 glycoprotein I antibodies; and (2) clinical symptoms of vascular thrombosis or pregnancy morbidity [1]. Patients with typical APS positivity have a high risk for recurrent thrombosis and should be given appropriate anticoagulation [2]. However, asymptomatic cases meeting only the laboratory criteria for APS are at lower risk for vascular complications. Whether they need a primary prophylaxis with low-dose aspirin is the matter of the present debate. To tackle this issue, the expected benefit/risk of ASA in the prevention of thrombosis and the results of recent clinical studies in this setting should be considered.

Lessons from primary prevention trials with aspirin outside APS

The use of aspirin in six “primary” prevention trials enrolling approximately 5 ...