Aspirin

Aspirin (acetylsalicylic acid) is one of the most widely used and extensively studied pharmacological agents in medicine, classified as a non-steroidal anti-inflammatory drug (NSAID) with potent antiplatelet, analgesic, antipyretic, and anti-inflammatory properties. Its primary mechanism of action involves irreversible inhibition of cyclooxygenase (COX) enzymes — specifically COX-1 and COX-2 — which blocks the conversion of arachidonic acid to prostaglandins and thromboxane A2 (TXA2). By suppressing platelet-derived TXA2, a potent platelet activator and vasoconstrictor, aspirin reduces platelet aggregation and thrombus formation, making it a cornerstone therapy in the prevention and management of cardiovascular and cerebrovascular disease. Its antiplatelet effects are permanent for the lifespan of a given platelet (~7–10 days), as platelets lack the nuclear machinery to synthesize new COX enzyme.

Beyond cardiovascular indications, aspirin is employed in a broad range of clinical settings including obstetric complications, antiphospholipid syndrome, ischemic stroke, and chronic coronary syndrome. It is often used in combination with other antithrombotic agents — including anticoagulants such as rivaroxaban, apixaban, and warfarin, as well as P2Y12 inhibitors such as clopidogrel and ticagrelor — to achieve additive or synergistic inhibition of thrombotic pathways. Emerging research also explores novel drug delivery platforms for aspirin and its potential role in reducing mortality in aging populations, reflecting the breadth of its pharmacological relevance.