Locally, thrombin is not only involved in coagulation; it has pro-inflammatory activity [ 80 ]. Thrombin can activate receptors on platelets and the vascular endothelium, leading to inflammation and tissue injury [ 81 ]. Activated platelets express CD40L and induce endothelial cells to secrete chemokines and to express adhesion molecules, indicating that platelets could initiate an inflammatory response of the vessel wall [ 82 ].
Interesting, it has recently been shown that besides their specific activity, lipid-lowering drugs [ 83 , 84 ], the novel group of antidiabetic drugs thiazolidinediones [ 85 , 86 ], and angiotensin-converting enzyme inhibitor, all exhibit anti-inflammatory properties. Their clinical benefits may to some extent derive from lowering inflammation [ 87 ].
The underlying inflammation of atheromata in acute coronary syndromes could be the basis of failure of intensive antithrombotic therapy [ 88 ]. COX-2 inhibition may decrease athero-inflammation, reducing monocyte infiltration and improving vascular cell function and plaque stability, resulting in a decrease of coronary athero-thrombotic events [ 53 ].
In our hands, the combination of a preferential COX-2 inhibitor, meloxicam, plus heparin and aspirin, proved superior to heparin and aspirin alone for reducing coronary thrombotic events in patients with acute coronary syndromes without ST-segment elevation [ 89 ]. In conclusion, aspirin resistance depends on circumstances independent of aspirin and could more aptly be termed aspirin failure. This is supported by the fact that increasing doses of aspirin can completely inhibit platelet aggregation in patients who are unresponsive or only partially responsive to aspirin [cited by [ 90 ]].
Otherwise, thrombin generated at the endothelial lesion can induce platelet activation, which is not affected by aspirin. All these findings indicate that, in acute coronary syndromes, there is a strong pro-clotting activity in the complicated atheroma. This activity is augmented by the underlying inflammation, which in several circumstances can overwhelm the inhibitory effects of single or combined anti-thrombotic drugs, including aspirin. FitzGerald GA: Parsing an enigma: the pharmacodynamics of aspirin resistance.
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A novel vasculo-protective action of aspirin. Effects of Simvastatin and Low-Dose Aspirin. Bjornsson TD, Schneider DE, Berger H Jr: Aspirin acetylates fibrinogen and enhances fibrinolysis: fibrinolytic effect is independent of changes in plasminogen activator levels. J Pharmacol Exp Ther , J Vasc Med Biol , 5: Eur Heart J , Watala C, Gwozdzinski K: Effect of aspirin on conformation and dynamics of membrane proteins in platelets and erythrocytes.
Biochem Pharmacol , Heart , Arterioscler Thromb Vasc Biol , JAMA , Esmon CT: Inflammation and thrombosis. Matthay MA: Severe sepsis-A new treatment with both anticoagulant and antiinflamatory properties. Coughlin SR: Thrombin signalling and protease-activated. For general information, Learn About Clinical Studies. Hide glossary Glossary Study record managers: refer to the Data Element Definitions if submitting registration or results information.
Search for terms. Save this study. Warning You have reached the maximum number of saved studies Effect of Aspirin on Hemostatic and Vascular Function After Live Fire Fighting The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.
Federal Government. Read our disclaimer for details. Last Update Posted : July 21, Study Description. The investigators hypothesize that an acute treatment of low-dose aspirin will lead to a decreased resting platelet activation, platelet aggregation, and clotting potential, b increased fibrinolytic potential following fire fighting, c no significant effect on endothelial function or arterial stiffness versus the placebo condition.
FDA Resources. Arms and Interventions. Acute single dosage of placebo provided 30 minutes prior to firefighting. Outcome Measures. Primary Outcome Measures : Vascular function [ Time Frame: Less than 60 minutes before initiating firefighting activity ] Vascular function will be assessed via pulse wave analysis, pulse wave velocity, carotid artery compliance, beta stiffness index, forearm rsistance artery vasodilatory capacity, and brachial artery blood flow.
Blood samples will be collected by a trained phlebotomist from the antecubital vein directly into vacutainers with little or no stasis using a gauge needle. Samples will be used to quantify platetlet number and function, fibrinogen, prothrombin and partial thromboplastin time, t-PA and PAI-1 activities and antigen.
Vascular function will be assessed via pulse wave analysis, pulse wave velocity, carotid artery compliance, beta stiffness index, forearm rsistance artery vasodilatory capacity, and brachial artery blood flow.
Eligibility Criteria. If you think you're having a heart attack, call or emergency medical services.
Don't delay calling for help. Aspirin alone won't save your life if you're having a heart attack. When you call for help, the emergency operator may tell you to chew an aspirin, but will first ask if you have an aspirin allergy or other health conditions that would make taking an aspirin unsafe. It's OK to chew an aspirin if your health care provider has previously told you to do so if you think you're having a heart attack — but always call or emergency medical services first.
Coated aspirin is also called enteric-coated aspirin. It is designed to pass through the stomach and not dissolve until it reaches the small intestine. Coated aspirin may be gentler on the stomach and may be appropriate for some people who take a daily aspirin, especially those with a history of gastrointestinal inflammation or ulcers. But there's no evidence that taking coated aspirin decreases the chance of developing gastrointestinal bleeding.
Also, coated aspirin may not work as well as plain aspirin when taken at the time of a possible heart attack. Talk to your health care provider if you're concerned about ways to decrease your bleeding risk. There is a problem with information submitted for this request. Sign up for free, and stay up-to-date on research advancements, health tips and current health topics, like COVID, plus expert advice on managing your health.
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A single copy of these materials may be reprinted for noncommercial personal use only. This content does not have an English version. This content does not have an Arabic version. See more conditions. Daily aspirin therapy: Understand the benefits and risks. Products and services. Daily aspirin therapy: Understand the benefits and risks Daily aspirin therapy can be a lifesaving option, but it's not for everyone. By Mayo Clinic Staff. Thank you for Subscribing Our Housecall e-newsletter will keep you up-to-date on the latest health information.
Please try again. Something went wrong on our side, please try again. Show references Aspirin use to prevent cardiovascular disease: Preventive medication. Preventive Services Task Force. Accessed Oct. Hennekens CH, et al. Aspirin for the secondary prevention of atherosclerotic cardiovascular disease. Aspirin and heart disease.
American Heart Association. Zheng SL, et al. Association of aspirin use for primary prevention with cardiovascular events and bleeding events: A systematic review and meta-analysis.
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