Interactions between aspirin and P2Y12 receptor antagonists in ischaemic heart disease

A combination of aspirin 75 mg once daily (OD) and the P2Y12 inhibitor ticagrelor represents the
current standard antiplatelet treatment for acute coronary syndromes (ACS). Prolonged therapy is
indicated in patients at high risk of ischaemic events but low risk of bleeding, though varying aspirin dose
and frequency of administration may modulate its actions and consistency of effect. Daily doses
of aspirin <75 mg may exert significant effect and twice-daily (BD) administration may improve
consistency, but these regimens have not been studied in those receiving ticagrelor. Aspirin
potentiates certain pathways of inflammation that may hypothetically drive atherogenesis and be
counteractive in atherothrombosis. This project characterised a novel regimen of very-low-dose
BD aspirin, when given alone and in combination with ticagrelor, compared to standard regimens
of aspirin and DAPT.