Recommendation and future directions
Although this study shows that aspirin resistance adversely affects clinical outcomes whenever aspirin is used alone or in combination with another antiplatelet agent, several issues need resolution or clarification:
Firstly, we strongly advise that doctors continue their current practice in prescribing aspirin for chronic therapy to prevent adverse cardiovascular events as the overall risk reduction is well reported.1 We also recommend that patients are fully informed about the possible adverse effects of aspirin as it is possible that the currently perceived overall benefit in all aspirin treated patients (about a 25% decrease in risk) is more likely offset by the fourfold increased risk in the 16% to 30% subpopulation of patients identified as aspirin resistant.
Studies need to be designed to determine the most useful test to identify aspirin resistance and identify alternative effective therapies for patients who are resistant to aspirin. Finally, we suggest that the term aspirin resistant is a misnomer. Aspirin non-responsiveness may be a more appropriate label until a better understanding is reached about what particular platelet function is involved.