Low dose aspirin and pregnancy: how important is aspirin resistance?

BJOG. 2016 Aug;123(9):1481-7. doi: 10.1111/1471-0528.13914. Epub 2016 Mar 1.

Abstract

Antiplatelet agents are pivotal for prevention of coronary artery disease and cerebrovascular disease worldwide. Individual patient data meta-analysis indicates that low-dose aspirin causes a 10% risk reduction in pre-eclampsia for women at high individual risk. However, in the last 15 years it has emerged that a significant proportion of aspirin-treated individuals exhibit suboptimal platelet response, determined biochemically and clinically, termed 'aspirin non-responsiveness', 'aspirin resistance' and 'aspirin treatment failure'. More recently, investigation of aspirin responsiveness has begun in pregnant women. This review explores the history and clinical relevance of 'aspirin resistance' applied to high-risk obstetric populations.

Tweetable abstract: Is 'aspirin resistance' clinically relevant in high-risk obstetrics?

Keywords: Activation; aspirin; platelet; pre-eclampsia; pregnancy; resistance.

Publication types

  • Review

MeSH terms

  • Aspirin / therapeutic use*
  • Bleeding Time*
  • Blood Platelets
  • Dose-Response Relationship, Drug
  • Drug Resistance / genetics
  • Drug Resistance / physiology*
  • Female
  • Humans
  • Medication Adherence*
  • Pharmacogenomic Variants
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Platelet Function Tests
  • Pre-Eclampsia / prevention & control*
  • Pregnancy
  • Pregnancy, High-Risk
  • Treatment Failure

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin