Acetylsalicylic acid resistance: risk factors, mechanisms, diagnostic tests

Acetylsalicylic acid (aspirin) is one the most widespread drugs in the world. It is used for secondary prevention of atherothrombotic events in patients with cardiovascular disease. Accordingly, the problem of the effectiveness of aspirin treatment is among the crucial issues of cardiology. The issue of personalization of antiplatelet therapy remains relevant, since there is no convincing evidence in favor of using aspirin for primary prevention in the general population. In this review, recent data on aspirin resistance are considered. Potential mechanisms of non-responsiveness to aspirin, the role of genetic factors, standardization of tests and diagnostic criteria for aspirin resistance, and the treatment options are discussed. The data on the clinical and prognostic value of 11-dehydrothromboxane B2 as a promising marker of thromboxane-dependent platelet activation are analyzed.