Aspirin is an important antithrombotic agent. However, its clinical benefit is impaired by aspirin resistance. The term of "aspirin resistance" usually refers to laboratory resistance. It can be identified by measuring thromboxane A2 or thromboxane-dependent platelet function. Clinical trials have shown that laboratory aspirin resistance is correlated with vascular events.
Aspirin ; therapeutic use ; Drug Resistance ; Humans ; Thromboxane A2 ; blood

No abstract availble.
Anticarcinogenic Agents/*therapeutic use ; Aspirin/*therapeutic use ; Colonic Neoplasms/*prevention & control ; Humans

This article reviews the available published data on optimizing clopidogrel and aspirin therapy using translational and integrative medicine. Translational and evidence-based medical studies show that the CYP2C19 gene mutation (CYP2C19*2 and CYP2C19*3) could affect > 50% of the Chinese population, and that this mutation is closely associated with clopidogrel resistance and an increased risk of major adverse cardiovascular events, particularly stent thrombosis in patients following percutaneous coronary intervention (PCI). Adjusted-dose warfarin and aspirin reduce stroke in patients with atrial fibrillation (AF), and warfarin is substantially more efficacious than aspirin. However, a poor compliance is a big problem in warfarin use especially in China. The genetic variants of vitamin K expoxide reductase might account for the universally lower warfarin dosage used in Chinese population. The available evidence indicates that the integrating mainstream treatments (e.g., clopidogrel, CYP2C19 genotyping) and non-mainstream medicines [e.g., Chinese medicines, Naoxintong Capsule (, NXT)] to treat CYP2C19 gene mutation patients following PCI can be effective. Aspirin combined NXT and the adjusted-dose warfarin was equally effective in elderly patients with non-valvular AF in prevention of ischemic stroke.
Aspirin ; therapeutic use ; Clopidogrel ; therapeutic use ; Humans ; Integrative Medicine ; Translational Medical Research

Kawasaki disease is far more frequent in children than in adults. The pathogenesis of Kawasaki disease is unknown, but it involves changes to the coronary artery and other diverse clinical manifestations. There are currently no specific laboratory diagnostic indexes, and especially since the disease is rare in adults, so it is extremely easy to misdiagnose or to overlook entirely. Our retrospective analysis of an diagnosis of and treatment for Kawasaki disease in an adult provides a guide to clinical doctors in terms of understanding Kawasaki disease, early diagnosis of it, and improved prognosis.
Adult ; Aspirin ; therapeutic use ; Humans ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnosis ; therapy ; gamma-Globulins ; therapeutic use

Acetaminophen ; therapeutic use ; Analgesics, Non-Narcotic ; therapeutic use ; Aspirin ; therapeutic use ; Fever ; drug therapy ; etiology ; Humans ; Ibuprofen ; therapeutic use ; Sulfonamides ; therapeutic use

Abdomen ; surgery ; Anticoagulants ; therapeutic use ; Aspirin ; therapeutic use ; Heparin ; therapeutic use ; Humans ; Pelvis ; surgery ; Postoperative Complications ; prevention & control ; Venous Thrombosis ; prevention & control ; Warfarin ; therapeutic use

OBJECTIVETobacco smoking results in increased platelet aggregability, which suggests that low-dose aspirin used in common clinical practice may not effectively inhibit platelet activity in smokers with coronary heart disease (CHD). This review was performed to assess the effect of aspirin on platelet aggregation in patients with CHD.

DATA SOURCESWe performed an electronic literature search of MEDLINE (starting from the beginning to March 15, 2009) using the term "smoking" or "tobacco" paired with the following: "platelet", "aspirin" or "coronary heart disease".

STUDY SELECTIONWe looked for review articles regarding the effect of tobacco smoking on platelet activity and on the anti-platelet efficacy of aspirin in healthy people and patients with CHD. The search was limited in "core clinical journal". In total, 1321 relevant articles were retrieved, and 36 articles were ultimately cited.

RESULTSTobacco smoking results in increased platelet aggregability, which can be inhibited by low-dose aspirin in the healthy population. However, in patients with CHD, the increased platelet aggregability can not be effectively inhibited by the same low-dose of aspirin. A recent study indicated that clopidogrel or an increased dose of aspirin can effectively inhibit the increased platelet aggregability induced by tobacco smoking in patients with CHD.

CONCLUSIONSIt is important for patients with CHD to quit smoking. For the current smoker, it may be necessary to take larger doses of aspirin than normal or take an adenosine diphosphate receptor inhibitor along with aspirin to effectively inhibit the increased platelet activity.

Aspirin ; therapeutic use ; Coronary Disease ; drug therapy ; Drug Interactions ; Humans ; Platelet Aggregation Inhibitors ; therapeutic use ; Smoking ; adverse effects

Aspirin ; therapeutic use ; Diagnosis, Differential ; Female ; Humans ; Immunoglobulins, Intravenous ; therapeutic use ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnosis

BACKGROUNDVenous thromboembolism (VTE) is an important complication after major orthopedic surgery. Pharmaceutical methods represent the main strategy of VTE prevention. The use of aspirin in VTE prevention is still controversial worldwide, especially in China. The purpose of this study was to evaluate the role of aspirin combined with mechanical measures in the prevention of VTE after total knee arthroplasty (TKA).

METHODSBetween January 2012 and May 2013 and in accordance with the inclusion criteria, 120 patients undergoing TKA were randomly allocated to two groups. To prevent VTE, patients in group A received aspirin combined with mechanical measures postoperatively, while patients in group B received low-molecular-weight heparin (LMWH) sodium and rivaroxaban sequentially in combination with mechanical measures postoperatively. All surgeries were performed by one surgeon using a posterior-stabilized cemented prosthesis. The two groups were followed up and compared for the incidence of deep vein thrombosis (DVT) by duplex ultrasound scan and clinical VTE events. The adverse events, the blood loss index, and the cost of VTE prevention were also compared.

RESULTSDVT was detected in 10 of 60 patients in group A (16.7%, 95% CI: 7.3%-26.1%) compared with 11 of 60 in group B (18.3%, 95% CI: 8.5%-27.8%) (P = 0.500). There is no statistical evidence supporting the inferior effect of aspirin in preventing DVT as compared with the other medications. There were no cases of symptomatic VTE or death during the follow-up period. Area of ecchymosis was lower in group A than in group B, and the differences were statistically significant. Patients in group A had the lower blood loss index as compared with patients in group B. No transfusion cases were found in both groups. The differences were statistically significant. The cost of VTE prevention analysis indicated a cost reduction using aspirin in group A compared with using LMWH and rivaroxaban in group B.

CONCLUSIONAspirin combined with mechanical measures had a good effect on prevention of VTE after TKA and resulted in lower cost, less blood loss, and less subcutaneous ecchymosis.

Aged ; Anticoagulants ; therapeutic use ; Arthroplasty, Replacement, Knee ; Aspirin ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Venous Thromboembolism ; prevention & control

BACKGROUND: Aspirin has demonstrated safety and efficacy for venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA); however, inconsistent dose regimens have been reported in the literature. This study aimed to evaluate and compare the safety and efficacy of 100 mg aspirin twice daily with rivaroxaban in VTE prophylaxis following THA. METHODS: Patients undergoing elective unilateral primary THA between January 2019 and January 2020 were prospectively enrolled in the study and randomly allocated to receive 5 weeks of VTE prophylaxis with either oral enteric-coated aspirin (100 mg twice daily) or rivaroxaban (10 mg once daily). Medication safety and efficacy were comprehensively evaluated through symptomatic VTE incidence, deep vein thrombosis (DVT) on Doppler ultrasonography, total blood loss (TBL), laboratory bloodwork, Harris hip score (HHS), post-operative recovery, and the incidence of other complications. RESULTS: We included 70 patients in this study; 34 and 36 were allocated to receive aspirin and rivaroxaban prophylaxis, respectively. No cases of symptomatic VTE occurred in this study. The DVT rate on Doppler ultrasonography in the aspirin group was not significantly different from that in the rivaroxaban group (8.8% vs. 8.3%, χ2 = 0.01, P = 0.91), confirming the non-inferiority of aspirin for DVT prophylaxis (χ2 = 2.29, P = 0.01). The calculated TBL in the aspirin group (944.9 mL [658.5-1137.8 mL]) was similar to that in the rivaroxaban group (978.3 mL [747.4-1740.6mL]) (χ2 = 1.55, P = 0.12). However, there were no significant inter-group differences in HHS at post-operative day (POD) 30 (Aspirin: 81.0 [78.8-83.0], Rivaroxaban: 81.0 [79.3-83.0], χ2 = 0.43, P = 0.67) and POD 90 (Aspirin: 90.0 [89.0-92.0], Rivaroxaban: 91.5 [88.3-92.8], χ2 = 0.77, P = 0.44), the incidence of bleeding events (2.9% vs. 8.3%, χ2 = 0.96, P = 0.33), or gastrointestinal complications (2.9% vs. 5.6%, χ2 = 1.13, P = 0.29). CONCLUSION: In terms of safety and efficacy, the prophylactic use of 100 mg aspirin twice daily was not statistically different from that of rivaroxaban in preventing VTE and reducing the risk of blood loss following elective primary THA. This supports the use of aspirin chemoprophylaxis following THA as a less expensive and more widely available option for future THAs. TRIAL REGISTRATION Chictr.org, ChiCTR18000202894; http://www.chictr.org.cn/showproj.aspx?proj=33284.
Anticoagulants ; Arthroplasty, Replacement, Hip/adverse effects* ; Arthroplasty, Replacement, Knee ; Aspirin/therapeutic use* ; Humans ; Rivaroxaban/therapeutic use* ; Venous Thromboembolism/prevention & control*