Aspirin vs heparin: a comparative review of antiplatelet and anticoagulant therapy
Abstract
Aspirin and Heparin are two widely used agents in the prevention and treatment of thromboembolic disorders, yet they differ fundamentally in their mechanisms of action, clinical applications and pharmacological profiles. Aspirin, an antiplatelet agent, primarily inhibits cyclooxygenase-1[COX1] thereby Suppressing thromboxane Az Synthesis and preventing platelet aggregation. It is mainly indicated in arterial thrombosis, such as myocardial infarction and stroke prevention. In contrast, heparin is an anticoagulant that enhances the activity of antithrombin 111, inhibiting thrombin and factor Xa, thus interfering with the coagulation Cascade. It is Commonly used in venous thromboembolism, deep vein thrombosis, pulmonary embolism, and during surgeries or dialysis. This review compares their pharmacodynamics, indications, side effect profiles and clinical outcomes, highlighting the Complementary yet distinct roles of antiplatelet and anticoagulant therapy. The selection between aspirin and heparin is guided by the type of thrombosis, patient risk factors, and therapeutic goals, underlining the importance of individualized treatment strategies in cardiovascular and hematological care.
DOI
https://doi.org/10.70604/learnint.v2i3.104References
1. Onishi A et al. (2016) Heparin and anticoagulation. Front. Biosci 21, 1372–1392
2. Mulloy B et al. (2016) Pharmacology of heparin and related drugs. Pharmacol. Rev 68, 76–141 [PubMed: 26672027]
3. Spadarella G et al. (2020) From unfractionated heparin to pentasaccharide: paradigm of rigorous science growing in the understanding of the in vivo thrombin generation. Blood Rev. 39, 100613 [PubMed: 31471127]
4. Contejean C (1895) Recherches sur les injections intraveineuses de peptone et leur influence sur la coagulabilite du sang chez le chien. Arch. Physiol. Norm. Pathol 7 45–53
5. Lam LH, Silbert JE, Rosenberg RD. The separation of active and inactive forms of heparin. BiochemBiophys Res Commun 1976; 69:570±577
6. Andersson LO, Barrowcliffe TW, Holmer E, et al. Anticoagulant properties of heparin fractionated by affinity chromatography on matrix-bound antithrombin III and by gel filtration. Thromb Res 1976; 9:575±583
7. Tollefsen DM, Majerus DW, Blank MK. Heparin cofactor II: purification and properties of a heparin-dependent inhibitor of thrombin in human plasma. J BiolChem 1982; 257:2162±2169
8. Rosenberg RD, Bauer KA. The heparin-antithrombin system: a natural anticoagulant mechanism. In: Colman RW, Hirsh J, Marder VJ, et al, eds. Hemostasis and thrombosis: basic principles and clinical practice. 3rd ed. Philadelphia, PA: JB Lippincott, 1994; 837±860
9. Hirsh J. Heparin. N Eng! J Med 1991; 324:1565-74
10. Fennerty AG, Thomas P, Backhouse G, et al. Audit of control of heparin treatment. BMJ 1985; 290:27±28
11. Reilly B, Raschke R, Sandhya S, et al. Intravenous heparin dosing: patterns and variations in internist's practices. J Gen Intern Med 1993; 8:536±542
12. Wheeler AP, Jacquiss RD, Newman JH. Physician practices in the treatment of pulmonary embolism and deep venous thrombosis. Arch Intern Med 1988; 148:1321±1325
13. LeBras P, Halfon P. Standardization of heparin therapy improves efficacy [letter]. Arch Intern Med 1992; 152:2140± 2143
14. Mulloy B, Hogwood J, Gray E, Lever R, Page CP. Pharmacology of Heparin and Related Drugs. Pharmacol Rev. 2016 Jan;68(1):76-141.
15. N.A. Afratis, K. Karamanou, Z. Piperigkou, D.H. Vynios, A.D. Theocharis
16. Tóth L, Muszbek L, Komáromi I. Mechanism of the irreversible inhibition of human cyclooxygenase-1 by aspirin as predicted by QM/MM calculations. J Mol Graph Model. 2013;40:99–109.
17. Sundstrom J, Hedberg J, Thuresson M, Aarskog P, Johannesen KM, Oldgren J. Low-dose aspirin discontinuation and risk of cardiovascular events. A Swedish Nationwide. Population-Based Cohort Study Circulation. 2017;136:1183–92.
18. Elwood P, Stillings M. New uses for old drugs: Aspirin — the first miracle drug. The Pharmaceutical Journal10 MAR 2001
19. Alegbeleye BJ, Akpoveso OP, Alegbeleye AJ, Mohammed RK, Esteban-Zubero E. The Novel Aspirin as Breakthrough Drug for COVID-19: A Narrative Review.
20. S. D. Bowler, S. M. Smith, and P. S. Lavercombe, “Heparin inhibits the immediate response to antigen in the skin and lungs of allergic subjects,” American Review of Respiratory Disease, vol. 147, no. 1, pp. 160–163, 1993
21. Z. Diamant, M. C. Timmers, H. van der Veen, C. P. Page, F. J. van der Meer, and P. J. Sterk, “Effect of inhaled heparin on allergeninduced early and late asthmatic responses in patients with atopic asthma,” American Journal of Respiratory and Critical Care Medicine, vol. 153, no. 6 I, pp. 1790–1795, 1996.
22. T. Ahmed, J. Garrigo, and I. Danta, “Preventing bronchoconstriction in exercise-induced asthma with inhaled heparin,” The New England Journal of Medicine, vol. 329, no. 2, pp. 90–95, 1993
23. R. Polosa, S. Magr`ı, C. Vancheri et al., “Time course of changes in adenosine 5???? -monophosphate airway responsiveness with inhaled heparin in allergic asthma,” Journal of Allergy and Clinical Immunology, vol. 99, no. 3, pp. 338–342, 1997.
24. A. M. Fal, M. Kraus-Filarska, J. Miecielica, and J. Malolepszy, “Mechanisms of action of nebulized low-molecular-weight heparin in patients with bronchial asthma,” The Journal of Allergy and Clinical Immunology, vol. 113, no. 2, supplement, p. S36, 2004.
Published
Abstract Display: 217 
PDF Downloads: 107 How to Cite
Issue
Section
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Deprecated: json_decode(): Passing null to parameter #1 ($json) of type string is deprecated in /home/lapinjournals/domains/lapinjournals.com/public_html/plugins/generic/citations/CitationsPlugin.php on line 68
.