Low-Dose Aspirin Therapy Inadequate in Some Patients

WEDNESDAY, Aug. 20 (HealthDay News) -- In patients with diabetes mellitus and coronary artery disease, low-dose aspirin may not adequately inhibit platelet function, researchers report in the August issue of the American Journal of Cardiology.

Mehmet A. Duzenli, M.D., of Selcuk University in Konya, Turkey, and colleagues examined 151 outpatients with type 2 diabetes mellitus and coronary artery disease who were taking 100 mg/day of aspirin, and determined aspirin responsiveness on the basis of platelet aggregometry. Non-responders and semi-responders were randomized to 300 mg/day of aspirin, or 100 mg/day of aspirin plus 75 mg/day of clopidogrel. Platelet aggregometry was repeated two weeks following randomization.

The researchers report that 40 percent (60 out of 151 patients) were aspirin non-responders or semi-responders. Both treatments significantly decreased platelet aggregation among aspirin non-responders, the investigators found. While both treatments also decreased platelet aggregation in semi-responders, significantly more patients achieved the desired level of platelet inhibition in the combined treatment compared to aspirin alone.

"In conclusion, aspirin 100 mg/day does not inhibit platelet function adequately in a significant number of patients with diabetes mellitus and coronary artery disease," the authors write. "Increasing the aspirin dose to 300 mg/day or adding clopidogrel to aspirin can provide adequate platelet inhibition in a significant number of those patients with impaired responses to low-dose aspirin."

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