Molecular Diagnosis & Therapy

, Volume 12, Issue 1, pp 55–56 | Cite as

Diagnostics for Aspirin Resistance

  • Paul A. Gurbel
  • Kevin P. Bilden
  • Udaya S. Tantry

The clinical efficacy of aspirin therapy in preventing thrombotic events that has been observed in major clinical trials has mainly been attributed to the inhibition of the platelet cyclo-oxygenase (COX)-1 enzyme. Based on the measurement of stable thromboxane derivatives, it was suggested that more than 95% inhibition of platelet COX-1 is required to observe any clinical efficacy of aspirin therapy.[1] Recently, reports of ‘aspirin resistance’ have emerged and its association with adverse clinical event occurrence has attracted major interest among clinicians as well as the general public.[2]

Laboratory methods that isolate the primary target of aspirin in platelets (i.e. inhibition of COX-1 by using arachidonic acid as an agonist in platelet aggregation measurements), have demonstrated that aspirin is highly effective in inhibiting platelet COX-1. However, the estimation of the prevalence of ‘aspirin resistance’ is highly assay-specific, and higher prevalence is significantly...


Aspirin Thromboxane Aspirin Therapy Aspirin Resistance Heart Outcome Prevention Evaluation 
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Dr Gurbel has received research grant and honoraria from Bayer, Astrazeneca, Schering Plough, Eli Lily, and Daiichi/Sankyo.

Drs Bilden and Tantry have no conflicts of interest that are directly relevant to the content of this commentary.


  1. 1.
    Reilly IA, FitzGerald GA. Inhibition of thromboxane formation in vivo and ex vivo: implications for therapy with platelet inhibitory drugs. Blood 1987; 69: 180–6PubMedGoogle Scholar
  2. 2.
    Tantry US, Bliden KP, Gurbel PA. Resistance to antiplatelet drugs: current status and future research. Expert Opin Pharmacother 2005; 6: 2027–45PubMedCrossRefGoogle Scholar
  3. 3.
    Gurbel PA, Bliden KP, DiChiara J, et al. Evaluation of dose-related effects of aspirin on platelet function: results from the Aspirin-Induced Platelet Effect (ASPECT) study. Circulation 2007; 115: 3156–64PubMedCrossRefGoogle Scholar
  4. 4.
    DiChiara J, Bliden KP, Tantry US, et al. The effect of aspirin dosing on platelet function in diabetic and nondiabetic patients: an analysis from the aspirin-induced platelet effect (ASPECT) study. Diabetes 2007; 56: 3014–9PubMedCrossRefGoogle Scholar
  5. 5.
    Snoep JD, Hovens MM, Eikenboom JC, et al. Association of laboratory-defined aspirin resistance with a higher risk of recurrent cardiovascular events: a systematic review and meta-analysis. Arch Intern Med 2007; 167: 1593–9PubMedCrossRefGoogle Scholar
  6. 6.
    Eikelboom JW, Hirsh J, Weitz JI, et al. Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events. Circulation 2002; 105: 1650–5PubMedCrossRefGoogle Scholar
  7. 7.
    Johnston M, Wentworth S, Lauzon M, et al. Comparision of two assays for the emasurement of urinary 11-dehydrothromboxane B2. J Thromb Haemost 2007; 5Suppl. 2: P–M–330Google Scholar

Copyright information

© Adis Data Information BV 2008

Authors and Affiliations

  • Paul A. Gurbel
    • 1
  • Kevin P. Bilden
    • 1
  • Udaya S. Tantry
    • 1
  1. 1.Sinai Center for Thrombosis ResearchBaltimoreUSA

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