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Aspirin: pharmacology and clinical applications
Enma V Paez Espinosa1, John P Murad, Fadi T Khasawneh
1Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, 309 East Second Street, Pomona, CA 91766, USA.
Insights
Aspirin, initially not an antiplatelet drug, is now a leading treatment for cardiovascular diseases and thrombosis. Despite new therapies, aspirin remains crucial for managing thrombotic disorders.
Area of Science:
- Pharmacology
- Cardiovascular Medicine
- Thrombosis Research
Background:
- Antiplatelet therapy is vital for reducing cardiovascular disease risks in patients with acute myocardial infarction, coronary artery bypass graft, and atrial fibrillation.
- Conventional treatments for thrombosis include heparin, oral anticoagulants, and aspirin, with aspirin being a widely prescribed antiplatelet agent.
- Aspirin's antiplatelet function was discovered after its initial development, highlighting a significant repurposing in medical treatment.
Purpose of the Study:
- To review the historical development and current role of antiplatelet agents in managing thrombotic and cardiovascular disorders.
- To emphasize the continued importance of aspirin in clinical practice despite the emergence of newer antiplatelet therapies.
- To discuss milestones in antiplatelet drug development, including adenosine diphosphate receptor inhibitors, phosphodiesterase inhibitors, and GPIIb/IIIa inhibitors.
Main Methods:
- Literature review of antiplatelet therapy and antithrombotic drug development.
- Analysis of the clinical application and efficacy of aspirin and other antiplatelet agents.
- Examination of the limitations of current antiplatelet therapies.
Main Results:
- Aspirin, though initially not designed as an antiplatelet agent, has become a cornerstone in managing cardiovascular diseases and thrombosis.
- Several classes of antiplatelet agents, including ADP receptor inhibitors, have been developed, offering alternatives to aspirin.
- Despite advancements, aspirin's efficacy and established role ensure its continued significance in clinical practice.
Conclusions:
- Aspirin remains a critical therapeutic option for thrombotic and cardiovascular disorders due to its effectiveness and established role.
- The development of novel antiplatelet agents addresses some limitations of older therapies but does not fully replace aspirin's utility.
- Future management of thrombotic disorders will likely involve a combination of established agents like aspirin and newer therapeutic options.
Abstract:
Antiplatelet therapy has been documented to reduce risks of cardiovascular disease after acute myocardial infarction, coronary artery bypass graft, and in chronic atrial fibrillation patients, amongst other risk factors. Conventional management of thrombosis-based disorders includes the use of heparin, oral anticoagulants, and the preferred antiplatelet agent aspirin. Interestingly, aspirin was not intended to be used as an antiplatelet agent; rather, after being repurposed, it has become one of the most widely prescribed antithrombotic drugs. To this end, there have been several milestones in the development of antiplatelet agents in the last few decades, such as adenosine diphosphate receptor inhibitors, phosphodiesterase inhibitors, and GPIIb/IIIa inhibitors. However, given some of the limitations of these therapies, aspirin continues to play a major role in the management of thrombotic and cardiovascular disorders and is expected to do so for years to come.
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