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Aspirin loading in coronary artery disease patients already taking aspirin: A systematic review

Hila Asham1, Ahmad Separham2, Mohammad Javad Kamali1

  • 1Department of Clinical Pharmacy, Faculty of Pharmacy, Tabriz University of Medical Sciences, Tabriz, Iran.

Journal of Cardiovascular and Thoracic Research
|November 19, 2025
PubMed

Insights

Aspirin reloading in coronary artery disease (CAD) patients already on aspirin therapy significantly reduces thromboxane B2 levels. This intervention shows a good safety profile, improving cardiovascular outcomes without increasing adverse events.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Aspirin is a standard treatment for established coronary artery disease (CAD).
  • Evidence on aspirin reloading in CAD patients on chronic aspirin therapy is limited.
  • A knowledge gap exists regarding the efficacy and safety of aspirin reloading in this specific patient population.

Purpose of the Study:

  • To systematically review the existing literature on aspirin reloading in patients with established CAD who are already receiving aspirin therapy.
  • To evaluate the impact of aspirin reloading on cardiovascular outcomes and safety markers.
  • To address the gap in evidence concerning aspirin reloading strategies in chronic aspirin users with CAD.

Main Methods:

  • A systematic review was conducted using PubMed, Embase, and the Cochrane Library until July 15, 2024.
  • Four studies involving 1187 individuals with CAD and prior chronic aspirin use were included.
  • Data extraction, risk of bias assessment, and meta-analysis of outcomes were performed by two independent authors.

Main Results:

  • Aspirin reloading was significantly associated with a reduction in thromboxane B2 levels (MD, -17.46; P<0.00001).
  • Beneficial effects were observed on thromboxane B2-related platelet reactivity and myocardial injury indexes.
  • No significant increase in adverse events, including bleeding or mortality, was noted.

Conclusions:

  • Aspirin reloading demonstrates potential to improve cardiovascular outcomes in CAD patients with chronic aspirin use.
  • The intervention appears to have a favorable safety profile.
  • Further randomized clinical trials are warranted to confirm these findings and establish robust evidence.

Keywords:
AspirinCoronary artery diseasesPercutaneous coronary interventionReloadingThromboxane B2

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