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The rebound phenomenon after aspirin cessation: The biochemical evidence

  • Author Footnotes
    1 These authors contributed equally to this work.
    ,
    Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    ,
    Author Footnotes
    3 RFA was partly supported by an unrestricted research grant from the University of Sydney.
    Richard F. Alcock
    Correspondence
    Corresponding author at: Department of Cardiology, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia.
    Footnotes
    1 These authors contributed equally to this work.
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    3 RFA was partly supported by an unrestricted research grant from the University of Sydney.
    Affiliations
    Department of Cardiology, Concord Repatriation General Hospital, Australia
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  • Author Footnotes
    1 These authors contributed equally to this work.
    ,
    Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Caroline J. Reddel
    Footnotes
    1 These authors contributed equally to this work.
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    ANZAC Research Institute, University of Sydney, Australia
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  • Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Gabrielle J. Pennings
    Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    ANZAC Research Institute, University of Sydney, Australia
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  • Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Graham S. Hillis
    Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Concord Repatriation General Hospital, Australia
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  • Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Jennifer L. Curnow
    Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Haematology, Concord Repatriation General Hospital, Australia
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  • Author Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    David B. Brieger
    Footnotes
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Cardiology, Concord Repatriation General Hospital, Australia
    Search for articles by this author
  • Author Footnotes
    1 These authors contributed equally to this work.
    2 All authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    3 RFA was partly supported by an unrestricted research grant from the University of Sydney.
      Aspirin is the most commonly used anti-platelet agent in the primary and secondary prevention of cardiovascular events, with approximately 5% of middle-aged adults on long-term therapy [
      • Jacobs E.J.
      • Thun M.J.
      • Bain E.B.
      • Rodriguez C.
      • Henley S.J.
      • Calle E.E.
      A large cohort study of long-term daily use of adult-strength aspirin and cancer incidence.
      ]. Despite the clinical observations of a clustering of events following cessation of aspirin treatment, there are few prospective studies investigating the potential mechanisms. There are two possible explanations for these events: the first is that the withdrawal of aspirin allows the prothrombotic manifestations of the underlying disease process to re-emerge, with clinical consequences. The second is that aspirin withdrawal is associated with a “rebound” phenomenon that is prothrombotic and/or proinflammatory, and plays a causative role in adverse events. This rebound hypothesis, as a scientific entity, can be defined as an increase in platelet reactivity following aspirin withdrawal, to a level exceeding that at baseline prior to initiation of aspirin therapy [
      • Sambu N.
      • Warner T.
      • Curzen N.
      Clopidogrel withdrawal: is there a “rebound” phenomenon?.
      ].

      Keywords

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