Aspirin related platelet reactivity as a determinant of ten year survival in high risk non-ST segment elevation myocardial infarction (NSTEMI) patients

Aspirin, the most commonly prescribed antiplatelet agent in clinical practice, forms a cornerstone of management in patients with established cardiovascular disease (CVD). The clinical efficacy and safety of aspirin when prescribed for secondary prevention is supported by a robust evidence base demonstrating a 24% reduction in mortality and a 25% reduction in serious adverse events without any increase in bleeding complications in the context of an acute myocardial infarction [ 1 ]. Nevertheless, numerous studies have shown that the antiplatelet effect of aspirin is not uniform and is often sub-optimal in a sizable proportion of patients [ 2 , 3 ]. Inadequate platelet inhibition following the administration of aspirin is associated with recurrent cardiovascular events and adverse outcomes in patients with coronary artery disease [ 2 ].