Why is Aspirin, everybody’s nemesis ?

Why is Aspirin, everybody’s nemesis ?

February 1, 2024 by dr s venkatesan

Here’s a present evaluation on a subject, which wants some Introspection

For a child, A stands for apple in kindergarten, whereas within the college of cardiac pharmacology, A would sound as Aspirin. Such is the significance of this drug, identified for its obedient, predictable effectivity in the complete spectrum of CAD proper from major prevention of CAD to emergent major angioplasty in Cath lab. Most of us may even agree, It’s a work horse drug, not just for the cardiologists , however has been an anchor drug in as many vital normal medical therapeutics, wherever platelets are to be passivated.

We’re effectively conscious of molecular foundation of this medication motion. Aspirin impacts most factors within the core axis of platelet adhesion , activation and aggregation both instantly or not directly .(Although, its only a COX 1 blocker) Its effectivity is backed by numerous papers with authenticated proof.

Remaining message

“Now, we, notice Aspirin is being focused and going through potential elimination “

Why is that this occurring ?

Aspirin acts by simply blocking thromboxane mediated platelet activation , it doesn’t antagonize adenosine triggered activation, therefore it’s ineffective is the argument. Some how, our thought school is intruded , and unable to appreciate, the identical query could be performed in reverse .

P2-Y12 blockers in no matter kind & style ,helplessly watch thromboxane A2 selling platelets activation , isn’t ? Please perceive, many instances of Clopidogrel and Ticagrelor resistance is seemingly associated to lack of help from the Aspirin .(Genetic P450 heterogenicity story doesn’t clarify this absolutely )

The opposite concern is Aspirin will increase the bleeding danger. It’s a excellent irony , this argument is strictly reverse the one mentioned above, Implying Aspirin could possibly be a extra highly effective anti-platelet agent.

It’s a obligation of each considered one of us, to seek out the true causes for such a bias towards Aspirin. Nonetheless sturdy the proof base, (that’s being created) It is vitally troublesome to consider , Aspirin is proven the exit door for tutorial causes.

Publish take a look at

If you wish to convert Twin-APT to Mono-APT , which is able to you jettison ?

A.Aspirin

B.Clopidogrel

C.Ticagrelor

D.Regardless of the guideline say.

E.Will go away it to the affected person to resolve.

Reference

1.Piera Capranzano, David Moliterno, Davide Capodanno, Aspirin-free antiplatelet methods after percutaneous coronary interventions, European Coronary heart Journal, 2024;, ehad876, https://doi.org/10.1093/eurheartj/ehad876

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