Encyclopedia of Behavioral Medicine

Living Edition
| Editors: Marc Gellman


  • William WhangEmail author
  • Ana Victoria Soto
Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-6439-6_1246-2



Drug that inhibits platelet aggregation.

Aspirin inhibition of the enzyme cyclooxygenase-1 (COX-1) in platelets prevents arachidonic acid-induced production of thromboxane A2, a potent mediator of platelet aggregation, as well as vasoconstriction. The half-life of aspirin is only 20 min in the plasma, but due to its irreversible effects on COX-1, the therapeutic effects can last the lifetime of the platelet, up to 1 week following administration (Patrono et al. 1985). Aspirin has been shown to reduce cardiovascular events in the setting of acute myocardial infarction and acute stroke (Antithrombotic Trialists’ (ATT) Collaboration 2002). It is also recommended that aspirin be administered (300–350 mg) to patients undergoing stent placement (Schwartz et al. 1988). Higher doses of aspirin (≥300 mg/day) have been shown to produce a greater effect on COX-2, thereby achieving anti-inflammatory and analgesic properties as well. Aspirin at those higher doses, though, has been shown to have gastrointestinal side effects such as bleeding by eroding the protective prostaglandins in the gut mucosa (Roderick et al. 1993).

For primary prevention of cardiovascular events, meta-analyses have indicated a reduction in myocardial infarction risk that is offset by an increase in risk of major gastrointestinal and extracranial bleeding. However, no reduction in cardiovascular events has been shown in a meta-analysis of studies involving patients with diabetes (Antithrombotic Trialists’ (ATT) Collaboration 2009; Stavrakis et al. 2011).


References and Further Reading

  1. Antithrombotic Trialists’ (ATT) Collaboration. (2002). Collaborative meta-analysis of randomized trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. British Medical Journal, 324, 71–86.CrossRefGoogle Scholar
  2. Antithrombotic Trialists’ (ATT) Collaboration. (2009). Aspirin in the primary and secondary prevention of vascular disease: Collaborative meta-analysis of individual participant data from randomised trials. Lancet, 373, 1849–1860.CrossRefGoogle Scholar
  3. King, S. B., 3rd, Smith, S. C., Jr., Hirshfeld, J. W., Jr., Jacobs, A. K., Morrison, D. A., Williams, D. O., et al. (2008). 2007 focused update of the ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. Journal of the American College of Cardiology, 51, 172–209.CrossRefGoogle Scholar
  4. Patrono, C., Ciabattoni, G., Patrignani, P., Pugliese, F., Filabozzi, P., Catella, F., et al. (1985). Clinical pharmacology of platelet cyclooxygenase inhibition. Circulation, 72, 1177–1184.CrossRefGoogle Scholar
  5. Roderick, J. P., Wilkes, H. C., & Meade, T. W. (1993). The gastrointestinal toxicity of aspirin: An overview of randomized controlled trials. British Journal of Clinical Pharmacology, 35, 219–226.CrossRefGoogle Scholar
  6. Schwartz, L., Bouassa, M. G., Lesperance, J., Aldridge, H. E., Kazim, F., Salvatori, V. A., et al. (1988). Aspirin and dipyridamole in the prevention of restenosis after percutaneous transluminal coronary angioplasty. The New England Journal of Medicine, 318, 1714–1719.CrossRefGoogle Scholar
  7. Stavrakis, S., Stoner, J. A., Azar, M., Wayangankar, S., & Thadani, U. (2011). Low-dose aspirin for primary prevention of cardiovascular events in patients with diabetes: A meta-analysis. The American Journal of the Medical Sciences, 341, 1–9.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of CardiologyColumbia University Medical CenterNew YorkUSA
  2. 2.Medicine – Residency ProgramColumbia University Medical CenterNew YorkUSA

Section editors and affiliations

  • Linda C. Baumann
    • 1
  1. 1.School of NursingUniversity of Wisconsin-MadisonMadisonUSA