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| Assessing
the Response to Aspirin in Cardiovascular
Disease.
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Assessing the Response to Aspirin in Cardiovascular
Disease
Understanding
Aspirin Response is Critical.
Cardiovascular
disease and stroke are the leading causes of death
and morbidity in the United States and Europe. The
cost of these enormous healthcare issues in the
United States alone is $145 billion.1-3
Despite significant advances in understanding the
causes of these diseases, improvements in the strategies
for identifying high-risk individuals, as well as
designing and implementing effective prevention
programs, cardiovascular disease has remained the
number one killer in the U.S. since 1900 and currently
claims more lives each year than the next five leading
causes combined.3
The Prevalence of Aspirin Resistance is Significant |
| "The
American Heart Association recommends aspirin…This
recommendation is based on sound evidence from
clinical trials showing that aspirin helps prevent
the recurrence of such events as heart attack,
hospitalization for recurrent angina, second strokes,
etc. (secondary prevention). Studies show aspirin
also helps prevent these events from occurring
in people at high risk (primary prevention).”
American
Heart Association. Aspirin in Heart Attack and
Stroke Prevention. 2003.4 |
Aspirin is the most widely consumed drug in the
world5 and it is
a cost-effective medication for the prevention and
treatment of heart disease and stroke.4,6
Aspirin inhibits platelet function
and may dampen the role of platelets as inflammatory
mediators, two factors strongly implicated in promoting
acute coronary syndromes (ACS).7,8
However,
mounting evidence suggests that significant insensitivity
(5% - 60%) to aspirin occurs among patients with
defined coronary disease and stroke.1,2,9,10
Given this, accurate dosing and therapeutic monitoring
of aspirin is not routinely conducted on patients
with ACS. Because it is not standard practice to
measure platelet function when patients are being
treated with antiplatelet drugs, this has led to
the principle of “one size fits all” strategy
for dosing aspirin.11
The problem with this approach is that there are
still patients who suffer ‘breakthrough’
events despite daily aspirin therapy.12,13 |
“Despite
the demonstrated benefit of aspirin in secondary
prevention and its possible beneficial effects in
selected individuals for primary prevention, there
remains a large segment of the population at risk
that does not benefit from aspirin.”
M.K.
Halushka and P.V. Halushka. Circulation
2002 |
For information on Proposed Mechanisms of Aspirin Resistance,
click here.
To
hear audioconferences on this important subject, click
here.
To
review a recent article on researchers who measured
aspirin resistance by PFA testing, click
here.
To
review the work from Dr. Mark Alberts, et al, Northwestern
University Memorial Hospital, click on the following
subject:
References
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