The genetics of aspirin resistance.

Aspirin is widely used for the prophylaxis of cardiovascular events in patients with cardiovascular risk factors or established atherosclerotic disease. However, despite aspirin treatment, a substantial number of patients experience recurrent events. Such 'aspirin resistance' is generally defined as failure of aspirin to produce an expected biological response, for example inhibition of platelet aggregation or of thromboxane A2 synthesis. Whilst its aetiology is multifactorial, genetic factors are also likely to play their part. Here we review the evidence for and against such a genetic contribution, as well as the data suggesting the involvement of specific genes.