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Aspirin

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Platelets in Thrombotic and Non-Thrombotic Disorders

Abstract

The last 35 years of clinical research on aspirin have proven its value as a lifesaving drug for the treatment and prevention of atherothrombosis. The place of low-dose aspirin in the therapeutic armamentarium has not been substantially altered by the successful development of new antiplatelet agents, including P2Y12 and PAR-1 receptor blockers. The demonstration of additive beneficial effects resulting from effective blockade of the platelet ADP and/or thrombin receptor combined with thromboxane suppression in high-risk patients is consistent with the multifactorial nature of atherothrombosis. Besides becoming an essential component of the antithrombotic strategy in high-risk settings, low-dose aspirin has also provided a mechanistic insight into the participation of platelets in other pathophysiologic processes, including colorectal cancer. The aim of this chapter is to review the mechanism of action and clinical pharmacology of aspirin as an antiplatelet agent, as well as the randomized trial evidence supporting its efficacy and safety. Moreover, more recent findings on additional long-term benefits of aspirin therapy will be discussed and new developments put into perspective.

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Acknowledgments

Dr. Patrono’s studies were supported by grants from the European Commission (FP6 EICOSANOX Consortium and FP7 SUMMIT Consortium) and from the Italian Ministry of University and Research (PRIN Project 2013). The expert editorial assistance of Ms. Daniela Basilico and Ms. Patrizia Barbi is gratefully acknowledged. Dr. Patrono has received consulting fees and an institutional grant from Bayer AG for investigator-initiated research on platelet activation in diabetes mellitus and is a member of the scientific advisory board of the Aspirin Foundation.

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Authors and Affiliations

  1. Department of Pharmacology, Catholic University School of Medicine, Largo Francesco Vito, 1, 00168, Rome, Italy

    Carlo Patrono MD, FESC

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  1. Carlo Patrono MD, FESC
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Correspondence to Carlo Patrono MD, FESC .

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Editors and Affiliations

  1. Department of Medicine, Section of Internal and Cardiovascular Medicine, University of Perugia , Perugia, Italy

    Paolo Gresele

  2. Houston Methodist Hospital , Houston, Texas, USA

    Neal S. Kleiman

  3. Bloodworks Northwest, University of Washington , Seattle, Washington, USA

    José A. Lopez

  4. Sackler Inst of Pulmonary Pharmacol, King’s College London, London, United Kingdom

    Clive P. Page

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Patrono, C. (2017). Aspirin. In: Gresele, P., Kleiman, N., Lopez, J., Page, C. (eds) Platelets in Thrombotic and Non-Thrombotic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-47462-5_83

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