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Semin Thromb Hemost 2007; 33(2): 210-214
DOI: 10.1055/s-2007-969036
Copyright © 2007 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Aspirin Resistance: Does It Exist?

Gundu H.R Rao1 , Jan Jaques Michiels2
  • 1Laboratory Medicine & Pathology, Lillehei Heart Institute, University of Minnesota, Minneapolis, Minnesota
  • 2Hemostasis & Thrombosis Research, University Hospital Antwerp, Antwerp, Belgium, and Goodheart Institute Rotterdam, Rotterdam, The Netherlands
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Publication History

Publication Date:
06 March 2007 (online)

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ABSTRACT

Aspirin irreversibly inhibits platelet cyclooxygenase-1 (COX-1). Aspirin sensitivity can be measured easily by its inhibition of arachidonic acid (AA) -induced platelet aggregation. Aspirin resistance has to be defined by its inability to inhibit COX-1. By using this definition, aspirin resistance very likely does not exist. A specific rapid laboratory test using either AA-induced platelet aggregation or AA-induced malondialdehyde production in platelet-rich plasma is needed to test aspirin sensitivity. The reports on so-called aspirin resistance are usually due to noncompliance of aspirin intake or consumption of inadequate doses of aspirin. In addition, data generated from using nonspecific platelet function tests have added confusion to this observed phenomenon of aspirin resistance.

KEYWORDS

Aspirin - aspirin resistance - aggregometry - laboratory testing - COX-1 - arachidonic acid - malondialdehyde

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Jan J MichielsM.D. Ph.D. 

Goodheart Institute, Erasmus Tower

Veenmos 13, 3069 AT Rotterdam, The Netherlands

Email: postbus@goodheartcenter.demon.nl