Aspirin and Vascular Disease

The US Preventive Services Task Force recommends the use of aspirin for prevention of cardiovascular disease (view the USPTF recommendations for aspirin). And over the years aspirin resistance has been documented in the literature, which has been a concern for providers prescribing the therapy for prevention of cardiovascular disease. In the March issue of Vascular Disease Management, editor in chief Frank Criado, MD, FACS, FSVM, discussed recent data on enteric-coated aspirin published in December in Circulation. The authors measured platelet-inhibition response to both immediate-release and enteric-coated aspirin and failed to find any true aspirin resistance. However, the authors did find that the enteric coating on aspirin, intended to prevent stomach upset, could be responsible for what was thought to be resistance.

“The study’s outcome is nothing short of an eye-opener that could have major impact on millions taking aspirin every day when and if enteric coating can be confirmed to be the culprit that causes pseudoresistance to the drug through absorption interference, and without providing proven protection against gastric side effects. The day may come when marketing-driven pressures become insufficient to perpetuate a bad practice,” writes Dr. Criado.

Aspirin is clearly still a useful therapy for this purpose, and measurement of its effectiveness is a focus for lab test manufacturers. On the newswire last week, we included a press release about AspirinWorks, the only FDA-cleared lab test that measures the urinary biomarker 11-dehydro thromboxane B2 (11dhTxB2) to determine aspirin effect. This test could be another useful tool to help physicians gauge aspirin’s ability to reduce the risk of heart attack and stroke.

 

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