Long-term ultra-low-dose aspirin therapy and platelet function

The effect of ultra-low-dose aspirin on platelet aggregation and thromboxane B2 (TXB2) production was studied in two groups of normal subjects. Group 1 received 162 mg/d and group 2 received 20 mg/d for 4 weeks. For the first 2 weeks the effects were similar in the two groups, namely inhibition of aggregation and inhibition of TXB2 production. However, after 4 weeks there was significantly less inhibition of platelet aggregation in those receiving 20 mg/d. Inhibition of TXB2 production in the two groups was not significantly different. Two of 9 individuals receiving 20 mg/d showed an escape from the aspirin effect by the 4th week. When 40 mg/d was given to these 2 individuals they again responded. A daily dose of 20 mg aspirin is therefore too small to maintain adequate inhibition of platelet function in normal subjects.