The Future of Aspirin Therapy in Cardiovascular Disease

Aspirin is an affordable, familiar, and most widely prescribed drug for acute and post cardiovascular events or revascularization procedures. It is also an essential member of dual antiplatelet therapy or DAPT (a P2Y12 inhibitor plus ASA) and dual pathway inhibition or DPI (Rivaroxaban plus ASA), and data for both combinations are increasing. Gastrointestinal bleeding is the most common adverse event associated with Aspirin therapy, the COGENT trial has shown that prophylactic PPI agents reduced this risk in Clopidogrel plus Aspirin DAPT therapy. Recently, phospholipid-coated formulation of ASA has been studied in comparison to regular uncoated ASA, the analysis suggests a faster antiplatelet effect, and the endoscopic evaluation has shown decreased ulceration. Further studies are necessary for fewer GI bleeding events and better adherence. Other novel formulations of ASA as inhaled nanoparticle was developed to enhance the speed of platelet inhibition and avoid gastric effects by evading GI and hepatic metabolism. In its Phase 1 study, the nanoparticle ASA formulation showed good sustained-release kinetics, increased anti-inflammatory properties, and faster platelet inhibition compared to regular chewing and swallowing of ASA. Thus, it is evident that as the role of Aspirin as monotherapy or DAP / DPI therapy is reappraised, newer formulations are developed to enhance the utility of this drug for its bright future. Disclaimer: Lupin makes no representation or warranty of any kind, expressed or implied, regarding the accuracy, adequacy, validity, reliability, availability or completeness of any scientific information shared by the HCP on the ­­­STAR UPDATE podcast. You should not allow the contents of this to substitute for your own medical judgment, which you should exercise in evaluating the information on this website.