Not all patients benefit from long-term aspirin therapy when prescribed to attenuate the risks of myocardial infarction, stroke and vascular-related deaths in patients with cardiovascular disease (CAD)1-3. More importantly, recent reports provide very convincing evidence that "aspirin resistant" patients are at a <4-fold increased risk of adverse cardiovascular events. Thus, aspirin resistance impacts adversely on clinical outcome. Despite these reports, the medical community at large has done little to resolve this issue. In particular, as no consensus has been reached on which test(s) best classifies a patient as aspirin resistance, and therefore best identifies which patient is at an increased risk of clinically important adverse events, it has been suggested that current clinical practice not change until the best test has been established, since aspirin remains the mainstay of secondary prevention for all patients with established cardiovascular disease.
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