Title:Antiplatelet Therapies: Aspirin at the Heart of New Directions
Volume: 13
Issue: 3
Author(s): Natalia Bunimov and Odette Laneuville
Affiliation:
Keywords:
Arthritis, aspirin, cardiovascular disease, cyclooxygenase (COX), nonsteroidal anti-inflammatory drugs (NSAIDs),
pain, platelet, prostaglandin endoperoxyde H synthase-1 (PTGS1).
Abstract: When introduced over 100 years ago, aspirin was prescribed as an analgesic drug to arthritic patients for pain
relief. The prevalence of users grew quite rapidly and to this day, aspirin remains widely used in clinical practice. The
popularity of aspirin resulted not only from its analgesic properties but also from a second benefit recognized later as an
anti-platelet effect. It was this important activity of aspirin that made it one of the most recommended drugs for the
treatment and prevention of cardiovascular diseases. The anti-platelet effect of aspirin emerged from the first few case
reports published in the early 1900s and was described as a mild bleeding. The molecular mechanisms involved were
described in 1971 and constituted the irreversible inhibition of cyclooxygenase-1 enzyme and prevention of platelet
aggregation. Today, the contribution of aspirin to our understanding of cardiovascular health persists and remains
considerable. Observations from large cohorts of aspirin users generate massive amount of valuable information used in
the identification of factors influencing the potential risk for cardiovascular diseases, including sex, age and genetic
predisposition. Aspirin and the path of discovery leading to its anti-platelet activity has taken a hundred years was based
on manifestations of effects observed in its users, and it remains a successful strategy for the identification of new avenues
to treat cardiovascular diseases associated with hyper-platelet activity. The contribution of aspirin to the understanding of
cardiovascular diseases and to the design of effective treatment and prevention strategies, remains of high importance in
our society.
