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Why does aspirin decrease the risk of venous thromboembolism? On old and novel antithrombotic effects of acetyl salicylic acid
Author(s) -
Undas A.,
BrummelZiedins K.,
Mann K. G.
Publication year - 2014
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/jth.12728
Subject(s) - aspirin , antithrombotic , medicine , platelet , cyclooxygenase , fibrinogen , coagulation , pharmacology , salicylic acid , cardiology , biochemistry , chemistry , enzyme
Summary It is well established that aspirin, an irreversible inhibitor of platelet cyclooxygenase activity, is effective in secondary prevention of arterial thromboembolic events. The pooled results of the recent randomized, multicenter WARFASA and ASPIRE aspirin trials showed a 32% reduction in the rate of recurrence of venous thromboembolism ( VTE ) in patients receiving aspirin following VTE . These clinical data support evidence that platelets contribute to the initiation and progression of venous thrombosis and aspirin inhibits thrombin formation and thrombin‐mediated coagulant reactions. In addition to the known acetylation of serine 529 residue in platelet cyclooxygenase‐1, the postulated mechanisms of aspirin‐induced antithrombotic actions also involve the acetylation of other proteins in blood coagulation, including fibrinogen, resulting in more efficient fibrinolysis. This review summarizes current knowledge on the aspirin‐induced antithrombotic effects that potentially explain clinical studies showing reduced rates of VTE events in aspirin‐treated subjects.