Aspirin resistance: biological and clinical implications
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Updated: Jul 7, 2026

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Published on: January 18, 2017
Stephanie Tseeng1, Rohit Arora
1Department of Cardiology, Chicago Medical School, VA Medical Center, North Chicago, IL 60064, USA.
Insights
Aspirin therapy helps prevent cardiovascular events, but some patients show aspirin resistance, meaning they don't fully benefit. The causes and clinical impact of this aspirin resistance remain unclear and require further investigation.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- Cardiovascular events are a leading cause of death in the US.
- Aspirin therapy is widely used for preventing atherothrombotic events.
- Varied patient responses to aspirin therapy necessitate understanding aspirin resistance.
Purpose of the Study:
- To address the unknown causes of aspirin resistance.
- To standardize the definition, measurement, and understanding of aspirin resistance.
- To investigate the link between low aspirin response and adverse clinical outcomes.
Main Methods:
- Further research is needed to define and measure aspirin resistance.
- Investigating the underlying mechanisms of aspirin resistance.
- Correlating aspirin response levels with clinical outcomes in patients.
Main Results:
- Aspirin resistance is a recognized phenomenon in cardiovascular medicine.
- The prevalence, precise definition, and measurement of aspirin resistance are not standardized.
- The clinical implications of aspirin resistance, including worsened outcomes, are not fully established.
Conclusions:
- Aspirin resistance is a significant clinical challenge in cardiovascular event prevention.
- Standardization of aspirin resistance assessment is crucial.
- Further research is essential to elucidate mechanisms and clinical relevance of aspirin resistance.
Abstract:
Cardiovascular events are the leading causes of mortality and morbidity in the United States. This development has prompted the rise of aspirin therapy in the prevention of atherothrombotic events. However, not all patients benefit to the same extent from aspirin therapy and many continue experiencing atherothrombotic complications. Researchers have labeled this phenomenon aspirin resistance, and despite drawing much attention from both researchers and lay people the cause remains unknown. Much needs to be clarified and standardized regarding the phenomenon of aspirin resistance, including the prevalence, definition, appropriate measurement methods, mechanisms, and, most important, linking low response to aspirin with worsened clinical outcomes.
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