REVIEW OF CURRENT GUIDELINES AND STUDIES ON USE OF ACETYLSALICYLIC ACID IN THE PRIMARY CARDIOVASCULAR EVENTS PREVENTION
DOI:
https://doi.org/10.56782/pps.29Keywords:
acetylsalicylic acid, prevention, cardiovascular events, glycineAbstract
Acetylsalicylic acid is a medicinal substance common use in medicine. The property of inhibiting platelet aggregation is widely used in the prevention of cardiovascular diseases. The role of acetylsalicylic acid is well established in the prevention of secondary cardiovascular events, while in the primary prevention of cardiovascular events, the opinions of researchers and cardiology association are divided. In the presented studies, acetylsalicylic acid reduced the risk of cardiovascular episodes, however, the risk of bleeding was often greater than the benefits of aspirin in primary prevention. There are many acetylsalicylic acid products available on the market. In order to minimize the risk of local irritation in the gastrointestinal tract, the use of film-coated formulations should be considered. The combination of acetylsalicylic acid and glycine seems promising, which increases the solubility of acetylsalicylic acid and has protective properties.
Downloads
References
Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat. New Biol. 1971, 231, 232–235. DOI: https://doi.org/10.1038/newbio231232a0
Grześk G, Koziński M, Navarese EP, Kubica A, Grześk E, Kubica J, Zieliński M. Kwas acetylosalicylowy – podstawa leczenia przeciwpłytkowego. Folia Cardiologica Excerpta. 2011, 6, 1, 49-61.
Vane JR, Botting RM. Mechanism of Action of Aspirin-Like drugs. Semin Arthritis Rheum. 1997, 6 Suppl 1, 2-10. DOI: https://doi.org/10.1016/S0049-0172(97)80046-7
Czyż M, Watała C. Aspirin – the prodigious panacea? Molecular mechanisms of the action of acetylsalicylic acid in the organism. Postepy Hig Med. Dosw. 2005, 59, 105-15.
Kubica J, Koziński M, Grześk G. Mechanizmy działania leków przeciwpłytkowych. Folia Cardiologica Excerpta. 2009, 4, 1, 10-17.
Piepoli MF, Hoes AW, Agewall S et al. Wytyczne ESC dotyczące prewencji chorób układu sercowo-naczyniowego w praktyce klinicznej w 2016 roku. Kardiologia Polska. 2016, 74, 9, 821–936.
Baigent C, Blackwell L et al. Antithrombotic Trialists’ Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009, 373, 1849–1860. DOI: https://doi.org/10.1016/S0140-6736(09)60503-1
Arnett DK et al. 2019 ACC/AHA Guideline on the Primary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2019, 19, S0735- 1097. DOI: https://doi.org/10.1001/jamacardio.2019.2604
Gaziano JM, Brotons C, Coppolecchia R, Cricelli C, Darius H, Gorelick PB, Howard G, Pearson TA, Rothwell PM, Ruilope LM. Use of aspirin to reduce risk of initial vascular events in patients at moderate risk of cardiovascular disease (ARRIVE): a randomised, double-blind, placebo-controlled trial. The Lancet. 2018, 392, 1036– 1046. DOI: https://doi.org/10.1016/S0140-6736(18)31924-X
ASCEND Study Collaborative Group, et al. Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus. N. Engl. J. Med. 2018, 379,16, 1529-1539. DOI: https://doi.org/10.1056/NEJMoa1804988
McNeil JJ, Wolfe R, Woods RL, Tonkin AM, Donnan GA, Nelson MR, Reid CM, Lockery JE, Kirpach B, Storey E. Effect of aspirin on cardiovascular events and bleeding in the healthy elderly. N. Engl. J. Med. 2018, 379, 16, 1509–1518. DOI: https://doi.org/10.1056/NEJMoa1805819
Kasprzak M, Koziński M, Kubica A, Navarese EP, Grześk G, Kubica J. An overview of methods dedicated to protection of the digestive tract in patients treated with aspirin. Focus on clinical effectiveness and antiplatelet properties. Kardiologia Polska. 2012, 70, 4, 405–413.
http://pub.rejestrymedyczne.csioz.gov.pl/ [Data dostępu: 23.03.2019 r.].
Hawthorne AB, Mahida YR, Cole AT, Hawkey CJ. Aspirin-induced gastric mucosal damage: prevention by enteric-coating and relation to prostaglandin synthesis. Br J Clin Pharmacol. 1991, 32, 77–83. DOI: https://doi.org/10.1111/j.1365-2125.1991.tb05616.x
Cox D, Maree AO, Dooley M, et al. Effect of Enteric Coating on Antiplatelet Activity of Low-Dose Aspirin in Healthy Volunteers. Stroke. 2006, 37, 8, 2153-8. DOI: https://doi.org/10.1161/01.STR.0000231683.43347.ec
Murtaza G, Karim S, Najam-ul-Haq M, Ahmad M, Ismail T, Khan SA, Bin AM, Hussain I. Interaction analysis of aspirin with selective amino acids. Acta Pol. Pharm. 2014, 71, 139-143.
Kusche W, Paxinos R, Haselmann J, Schwantes U, Breddin HK. Acetylsalicylic acid tablets with glycine improve long-term tolerability in antiplatelet drug therapy. Adv. Ther. 2003, 20, 237–245. DOI: https://doi.org/10.1007/BF02849852
Müller P, Dammann HG, Bergdolt H, Simon B. The effect of glycine on the gastroduodenal tolerability of acetylsalicylic acid. An endoscopic, controlled double-blind study in healthy subjects.
Arzneimittelforschung. 1991, 41, 812–814. DOI: https://doi.org/10.1212/WNL.41.6.812
Downloads
Published
Issue
Section
License

This work is licensed under a Creative Commons Attribution 4.0 International License.
For all articles published in Prospects in Pharmaceutical Sciences copyright is retained by the authors. The journal publishes articles in the Open Access policy, within the CC BY 4.0 licence.
This is a human-readable summary of (and not a substitute for) the license. Disclaimer.
You are free to:
Share — copy and redistribute the material in any medium or format
Adapt — remix, transform, and build upon the material for any purpose, even commercially.
The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where your use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all of the permissions necessary for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.