In patients reacting allergic to ASA (usually with an exanthema), a sensitisation strategy might help to get rid of symptoms within a few days. Biochemical ASA resistance is rare in patients who are actually taking and absorbing the agent, and routine testing is not indicated. Bleeding events with ASA are more commonly of gastric origin, and occur at a frequency of ≈2% per year. Bleeding events are increased by aspirin and seem to be higher at doses of >100 mg. The beneficial effects of ASA appear to occur at a dose of a minimum of 75 mg daily, with no additional benefit provided using higher doses. AA: arachidonic acid ADP, adenosine diphosphate CYP, cytochrome P450 GP indicates glycoprotein TP, thromboxane receptor and TxA 2, thromboxane A 2. Advances in understanding the mechanisms by which platelets participate in atherothrombotic processes have led to the search for the development of new drugs capable of consistently inhibiting platelet activity with maximum safety (figure 1).ĭifferent platelet receptors are activated by various agonists and serve as the target of various antiplatelets, which have been evaluated in large randomized clinical trials. In primary prevention, the potential benefit of the preventive use of Acetylsalicylic acid (ASA) should be carefully assessed and individualized. The use of antiplatelet agents, especially in secondary prevention of recurrent cardiovascular events is supported by several studies that evaluated their efficacy and safety. Platelets play an essential role in the pathogenesis of atherothrombotic events, justifying the use of antiplatelet agents in their prevention.
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