From Aspirin to Aspirin Resistance – History, Biochemical Background, Diagnostics and Clinical Relevance

Abstract

The story of success of aspirin has lasted for more than 100 years. Initially used as an analgetic with anti-inflammatory, antirheumatic as well as antipyretic effects, aspirin has been widely used as antithrombotic drug since the 1970s, too, due to its more recently discovered platelet inhibitory efficacy. Primary and secondary prophylaxis of cardiovascular events by long-term intake of aspirin has been performed million-fold worldwide, even without any medical attendance. In spite of a clear positive effect on the incidence of coagulation disorders, a residual risk remains for the aspirin user - the aspirin resistance. In this review a short historical survey is given, and the biochemical background of the aspirin effect on blood platelets as well as aspirin resistance with the possible causes and the clinical relevance are described. Different laboratory methods for detection of aspirin resistance are discussed with respect to validity and limitations. Not until both the predisposition for aspirin resistance and the presence of acute aspirin resistance can be clearly detected using reliable methods, the patient will receive adequate treatment.

Cellular Haemostaseology II – Impact of Platelet Function Testing for Coagulation Management and Platelet Substitution Therapy

“…A practical approach to set up a near-patient testing facility within the emergency department is outlined and data on local feasibility provided. The concise review by Götz Nowak [3] focuses on the evaluation of the suitability of the different platelet function test systems for the prediction of resistance to antiplatelet drugs. The restrictions of each method are presented to promote an optimal selection of diagnostic tests.…”