Comments and explanations for the BMJ's article on 'Discontinuation of aspirin for secondary prevention' (July 2011)

Aspirin, or acetylsalicylic acid is a commonly used drug for a wide range of conditions requiring prevention of clotting, analgesia and the reduction of inflammation. These effects are mainly due to aspirin's ability to inactivate irreversibly the COX (cylooxygenase) enzyme which is partly responsible for the production of thromboxanes.  Thromboxanes are a lipid and a vasoconstrictor, responsible for action in the clotting process. Thus by reducing this clotting agent aspirin can prevent such conditions as venous thromboembolism, colorectal cancer and  myocardial infarction (heart attack).

The BMJ article expressed concern and evidence to explain the negative effects of patients that do not take there medication. Evidence from Garcia Rodriguez's study showed that patients with non-fatal myocardial infarction that have had aspirin discontinued are have significantly increased risk of future myocardial infarction. Whereas there was no significant difference found when coronary heart disease patients stopped taking aspirin.

Conversely aspirin has the drawbacks of varying greatly from individual to individual, mainly because of the way the mechanism of aspirin that I outlined above works. Furthermore the use of aspirin is more difficult to medicate with patients with diabetes and some other subsets of conditions.

Conclusively  Rodriguez's research is so vital to patients, doctors and the general understanding of science: outlining that thrombotic  events can occur just 11-15 days after stopping the medication. Additionally from a drug design point of view aspirin is such a cheap, effective and safe drug to use that with the additional high risk to benefit ratio of the drug, making aspirin such a success in the pharma industry.

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