ArticleTH open : companion journal to thrombosis and haemostasis2026
Aspirin Dosing Frequency and Dose Influence Thromboxane Suppression Despite Uniform Inhibition of Arachidonic Acid-induced Platelet Aggregation.
Article in TH open : companion journal to thrombosis and haemostasis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Incomplete thromboxane suppression with 81 mg aspirin daily is common and predicts higher vascular risk. We compared the effects of aspirin in controls and patients with cardiovascular disease and tested strategies to improve thromboxane suppression. Methods: Two-phase randomized, open-label pharmacodynamic study. In Phase 1, controls and patients received enteric-coated (EC) aspirin 81 mg daily for 3 weeks. In Phase 2, the best responders within each cohort were randomized to EC aspirin 81 mg daily, EC aspirin 81 mg alternate daily, or soluble aspirin 81 mg daily, and the poorest responders to EC aspirin 81 mg daily, 325 mg daily, or 162 mg twice daily. Where results with EC and soluble aspirin 81 mg daily were similar, these arms were pooled for comparisons of daily versus alternate daily dosing. Outcome measures were light transmission aggregation in response to arachidonic acid, adenosine diphosphate, and collagen; serum thromboxane B2 (sTXB2); and urinary 11-dehydro-thromboxane B2 (uTXB2; creatinine-normalized). Results: We enrolled 136 controls and 115 patients. Among controls, EC aspirin 81 mg daily suppressed platelet aggregation and reduced sTXB2 from 238.4 to 2.7 ng/mL and uTXB2 from 112.0 to 39.0 ng/mmol creatinine (all Conclusion: Daily low-dose aspirin suppresses aggregation and serum thromboxane, but urinary thromboxane metabolites are less completely suppressed in patients with established cardiovascular disease. Alternate daily dosing attenuates thromboxane suppression, whereas divided dosing improves suppression in the poorest responders.
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