Panagiotis Iliakis: The ANDAMAN Trial and the Challenge of Aspirin Resistance
Panagiotis Iliakis, Interventional Cardiology and Research Fellow at Knappschaft Kliniken Universitätsklinikum Bochum, Fellow of European Society of Hypertension (FESH) at ESH, shared a post on LinkedIn:
”European Society of Cardiology – Working Group on Thrombosis
Paper of the Month
Aspirin dosing after acute coronary syndrome in patients with suspected aspirin resistance – insights from the ANDAMAN trial
Panagiotis Iliakis Dario Bongiovanni Diana Gorog Bruna Gigante
In our recent ESC WG on Thrombosis comment, we provide a critical appraisal of the ANDAMAN trial, recently published in the European Heart Journal, evaluating twice-daily versus once-daily aspirin dosing in patients with acute coronary syndrome and suspected aspirin resistance.
Can intensified aspirin dosing improve outcomes in high-risk ACS patients with enhanced platelet turnover, such as those with diabetes or obesity?
Despite a strong pharmacological rationale, twice-daily aspirin did not significantly reduce major adverse cardiovascular events compared with standard once-daily dosing.
The trial highlights the complex relationship between platelet inhibition and clinical outcomes, emphasizing that improved pharmacodynamic profiles do not always translate into improved prognosis.
These findings support current guideline-based aspirin strategies while underscoring the need for more individualized antithrombotic approaches in selected high-risk populations.”
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