NEW ORLEANS, March 27 -- Aspirin resistance is more common among diabetics patients than nondiabetics, potentially requiring higher doses for adequate protection against a heart attack, researchers here said Resistance to low-dose aspirin recommended for cardioprotection was found among 13% to 37% of patients with diabetes but only 3% to 14% of nondiabetic patients with a history of coronary artery disease, said Paul A. Gurbel, M.D., of Sinai Hospital and Johns Hopkins in Baltimore.
Testing by platelet aggregation or thromboxane metabolite generation showed that increasing the dose to 162 mg or 325 mg eliminated the difference between groups, he reported at the American College of Cardiology meeting.
"The one size fits all mentality is not really appropriate in diabetic patients," Dr. Gurbel said. "In selected diabetic patients baby aspirin is not enough."
However, further evidence from larger studies would be needed before routine high-dose aspirin -- which increases bleeding risk -- or routine aspirin resistance testing could be recommended for patients with diabetes, he cautioned.
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