Salutary effects of aspirin in coronary artery disease are not limited to its platelet inhibitory effects

Abstract

Summary:Aspirin is widely used in the treatment and prevention of coronary artery disease (CAD). However, other platelet inhibitory agents, which inhibit platelet activation, have not been found to be effective or as effective as aspirin. The discrepancy between the efficacy of these compounds and aspirin suggests that the therapeutic efficacy of aspirin may not be limited to its platelet inhibitory effect. In this review, the basis for a unique place for aspirin in the therapy of patients with CAD is discussed. The author believes that the nonplatelet-mediated effects of aspirin could be more important than the platelet inhibitory effect, or at least may complement the platelet inhibitory effects of aspirin in patients with acute myocardial ischemia and in others undergoing intracoronary procedures.

Aspirin inhibits ox-LDL-mediated LOX-1 expression and metalloproteinase-1 in human coronary endothelial cells

“…Aspirin is believed to be effective primarily by inhibiting platelet aggregation, but inhibition of inflammation [8], smooth muscle cell proliferation [9] and oxidative process [10,11] also contribute to aspirin's effects. Stimulation of apoptosis [12] and NO synthesis [13,14] by aspirin may also relate to its overall salutary effect.…”

Systemic and central nervous system vasculitides

“…Given the prominent scarring and early atherosclerosis reported in patients with systemic vasculitis with long-term survival, maintenance with antiplatelet agents would appear to be useful, although long-term studies have not been conducted. We recommend daily aspirin for patients after treatment of isolated angiitis as well as for a variety of disorders involving vasculitis of the peripheral nervous system [40]. Aspirin is indicated for thrombosis prophylaxis.…”

Stimulation of endothelial progenitor cells: a new putative effect of several cardiovascular drugs

“…It is a cornerstone of therapy in acute coronary syndromes and has been shown to reduce atherosclerosis-related events in a multitude of clinical studies [97,98]. Kharbanda et al have reported a protective effect of aspirin against endothelial dysfunction [99].…”