BMJ  2004;328:477-479 (28 February), doi:10.1136/bmj.328.7438.477

Editorial

Aspirin resistance

May be a cause of recurrent ischaemic vascular events in patients taking aspirin

The first 150 words of the full text of this article appear below.

Aspirin reduces the odds of serious atherothrombotic vascular events and death in a broad category of high risk patients by about one quarter.¹ The primary antithrombotic mechanism is believed to be inhibition of the biosynthesis of thromboxane (and thus platelet activation) by inactivation of platelet cyclo-oxygenase-1. However, aspirin is not that effective. It still fails to prevent most (at least 75%) serious vascular events in patients with symptomatic atherothrombosis.¹ Recurrent vascular events in patients taking aspirin ("aspirin treatment failures") have many possible causes (box), and aspirin resistance has emerged as an additional contender.^{2 3}

But what is aspirin resistance? Aspirin resistance has been used to describe several different phenomena. One is the inability of aspirin to protect patients from ischaemic vascular events. This has also been called clinical aspirin resistance.⁴ However, this definition is non-specific and could apply to any of the conditions listed in the box. Furthermore, it is not . . . [Full text of this article]

Stroke Unit, Department of Neurology, Royal Perth Hospital, Box X2213 GPO, Perth, WA 6001, Australia (gjhankey@cyllene.uwa.edu.au)

Department of Haematology, Royal Perth Hospital

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