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Aspirin resistance – does it clinically matter?

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Summary

A variable responsivenessto acetylsalicylic acid(ASA) is a clinical reality that doesnot principally differ from variableresponses to other kinds of drugtreatment in other therapeuticfields. Two questions arise: (i) isany resulting “treatment failure”due to a pharmacological failure ofthe drug to act and (ii) is any reducedantiplatelet activity to ASArelated to the clinical outcome ofthe patient?

Two major laboratory techniquesare available to quantifyplatelet variability to ASA ex vivo: Measurement of platelet functionand measurement of thromboxaneformation. Both methods havelimitations and did not yet resultin a generally accepted definitionof a pharmacological ASA “resistance”.

A “true” pharmacological resistanceto ASA exists in selectedgroups of patients. However, unlessmore information is available,results from in vitro assays ofplatelet function should not beover-interpreted. More data fromprospective trials are required,predominantly by measuring serumthromboxane formationwhich is a platelet-specific, ASAsensitivereaction. At this time,there is no reason to change therecommended daily maintenancedose of about 100 mg ASA withoutparticular requirements in patientswho need coronary protection.

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Authors and Affiliations

  1. Institut für Pharmakologie und Klinische Pharmakologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Universitätsstr. 1, Geb. 22.21, 40225, Düsseldorf, Germany

    Karsten Schrör MD, T. Hohlfeld & A.-A. Weber

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  1. Karsten Schrör MD
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  2. T. Hohlfeld
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  3. A.-A. Weber
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Correspondence to Karsten Schrör MD.

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Schrör, K., Hohlfeld, T. & Weber, AA. Aspirin resistance – does it clinically matter?. Clin Res Cardiol 95, 505–510 (2006). https://doi.org/10.1007/s00392-006-0424-5

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