BMJ  2008;336:291 (9 February), doi:10.1136/bmj.39479.465706.3A

Letters

Aspirin "resistance"

What is the risk of cardiovascular morbidity?

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

The increased risk of vascular disease in a subgroup of patients judged to be "resistant" to aspirin led Krasopoulos et al to propose that there could be beneficial effect of aspirin of greater than 50% in aspirin sensitive patients.1

The problem is identifying subjects "resistant" to aspirin. Krasopoulos et al accepted evidence from the authors of 20 reports of randomised aspirin trials of an inhibition of the expected platelet response to aspirin, however measured. The platelet tests had been done in hospital before the patients were admitted to the trials. The authors therefore dismiss the possibility that the lack of benefit during the trial was simply due to poor compliance with aspirin taking.

Compliance could still partly explain the findings. In one study only one of the 17 patients who had been judged to be aspirin resistant failed to show the expected platelet response to aspirin when aspirin was taken . . . [Full text of this article]

Peter Elwood, honorary professor, Gareth Morgan, secretary, Welsh Aspirin Group

1 Department of Primary Care and Public Health, Cardiff University Cardiff CF10 3XQ

pelwood@doctors.org.uk


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Relevant Article

Aspirin "resistance" and risk of cardiovascular morbidity: systematic review and meta-analysis
George Krasopoulos, Stephanie J Brister, W Scott Beattie, and Michael R Buchanan
BMJ 2008 336: 195-198. [Abstract] [Full Text] [PDF]

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