Aspirin resistance increases risk of death

DALLAS, March 26 For the first time, researchers have shown that people who are aspirin resistant have a higher risk of dying from heart disease than people who are not aspirin resistant, according to a study in todays rapid access issue of Circulation: Journal of the American Heart Association.

Aspirin blocks the formation of thromboxane A2, a chemical in the body that makes platelets sticky and promotes blood clotting. However, lead author John W. Eikelboom, MBBS, says it appears that aspirin does not effectively block thromboxane synthesis in some people. This makes them resistant to the protective effects of the drug.

In the study, patients taking aspirin who had a high level of thromboxane in their urine had a 3.5 times higher risk of cardiovascular death than patients who had the lowest level says Eikelboom, a clinical lecturer at the University of Western Australia, Royal Perth Hospital, Perth, Australia.

The American Heart Association recommends aspirin for all patients with artery disease and a second antiplatelet medicine for those with uncontrolled chest pain called unstable angina.

Eikelboom cautions that the findings dont suggest a need to limit aspirin use. For most patients, aspirin therapy can reduce the risk for cardiovascular events by 25 percent. Our results suggest that some patients may need more protection than aspirin alone can offer, he says.

Researchers used data collected by the Heart Outcomes Prevention Evaluation (HOPE) study. This was a randomized, placebo-controlled study that compared the efficacy of a blood pressure drug, ramipril, and vitamin E to prevent heart attacks or stroke in patients with heart disease. The current study is based on data collected on 5,529 patients enrolled at 129 Canadian study sites. All patients provided baseline urine specimens, which were analyzed for levels of a chemical called 11-dehydro thromboxane B2, a byproduct of thromboxane A2.

High levels of 11-dehy

Contact: Carole Bullock
American Heart Association

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