Abstract
Aspirin resistance seems to be an emerging clinical entity thatneeds to be recognized. The concept of aspirin resistance hasbeen based essentially on laboratory tests exploring plateletactivation. Patients who responded to platelet agonists, despiteaspirin treatment, have been considered resistant to the drug.Also, recurrence of cardiovascular events in patients givenaspirin has been considered another element in favor of theexistence of aspirin resistance.This apparently new clinical entity has focused the attentionof researchers, and many reviews on this topic have beenpublished. We analysed such reviews published from January2005toFebruary2006toverifyifthereisaconsensusonthedefinition of aspirin resistance or if there are some ambiguitiespresent in the definition that need to be carefully taken intoaccount.We found six reviews that fully examined aspirin resistanceand provided laboratory and clinical definitions (Table 1). Asfar as laboratory definition is concerned, some reviews [1–4]acknowledged that laboratory tests measuring ex vivo plateletfunction are unreliable and that the term aspirin resistance isambiguous and should be abandoned [1]; others suggested thatlaboratory tests may help to identify patients who are aspirin-resistant [5,6]. So far, laboratory tests used to explore theexistence of aspirin resistance included ex vivo tests of plateletfunction that are only in part dependent on the principalmechanism of action of aspirin, that is, the irreversibleinhibitionofcyclo-oxygenase-1.Thus,theyareneithersensitivenor specific in exploring the pharmacologic activity of aspirin.In accordance with this suggestion we have previouslyproposed that the existence of aspirin resistance, if any, shouldby substantiated by simultaneous analysis of ex vivo tests ofplatelet function and platelet thromboxane (Tx) A
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