Aspirin and aspirin resistance in coronary artery disease

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▸ Aspirin resistance is the inability of aspirin to reduce platelet activation and aggregation. ▸ Aspirin resistance has been defined both as a clinical and laboratory entity. ▸ There is no standardized laboratory method for the diagnosis of aspirin resistance. ▸ The mechanisms of aspirin resistance are not fully understood. ▸ The implications of aspirin resistance in clinical practice remain controversial.

Aspirin is still the mainstay of antiplatelet therapy in the secondary prevention of coronary artery disease. However certain patients do not benefit from the antithrombotic effects of aspirin.

The phenomenon of so-called aspirin resistance can be considered from the clinical and laboratory perspective. A variety of methods have emerged for the laboratory diagnosis of aspirin resistance. None of them is considered ideal as they provide conflicting information with significant inter-individual variability and weak correlation between them. With the mechanisms of aspirin resistance not fully understood and the phenomenon commonly observed in individuals with poor compliance, the existence of aspirin resistance has been challenged.

The aim of this review is to present recent data on the impact of aspirin resistance in primary and secondary prevention of coronary artery disease.

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