Open AccessThe Role of Aspirin Resistance in the Treatment of Acute Coronary Syndromes
Author(s) -
Lancaster Gilead I.,
Jain Hitender,
Zarich Stuart W.
Publication year - 2008
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20157
Subject(s) - medicine , aspirin , acute coronary syndrome , timi , heparin , thrombus , cardiology , low molecular weight heparin , intensive care medicine , myocardial infarction , thrombolysis
The TIMI Risk Score recognizes prior aspirin use as an independent risk factor for adverse outcomes in subjects presenting with an acute coronary syndrome. The etiology of this increased risk awaits clarification, but prior aspirin use may be associated with altered thrombus composition which is more resistant to current treatment modalities as compared to thrombus formation in subjects without prior aspirin use. Post hoc analysis of acute coronary syndrome trials has shown that prior aspirin users treated with unfractionated heparin are at particularly high risk. The addition of glycoprotein IIb/IIIa receptor inhibitor to unfractionated heparin or substitution of low‐molecular‐weight heparin significantly improves outcomes in prior aspirin users. The prognostic significance of prior aspirin use in acute coronary syndromes has important implications not only in clinical practice, but also in the design and interpretation of clinical trials. Copyright © 2007 Wiley Periodicals, Inc.