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Aspirin

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Antiplatelet therapy

Definition

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...

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References and Further Reading

  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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  • 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.

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Correspondence to William Whang .

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Whang, W., Soto, A.V. (2019). Aspirin. In: Gellman, M. (eds) Encyclopedia of Behavioral Medicine. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6439-6_1246-2

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  • DOI: https://doi.org/10.1007/978-1-4614-6439-6_1246-2

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  • Print ISBN: 978-1-4614-6439-6

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