{"id":"55e28b72232f","type":"article","url":"https://hartvaat.nl/2026/02/11/andaman-aspirinedosering-na-acs-met-verdenking-aspirineresistentie/","title":"ANDAMAN: aspirinedosering na ACS met verdenking aspirineresistentie","title_en":"Aspirin dosing after acute coronary syndrome with suspected aspirin resistance: the ANDAMAN trial.","category":"preventie","category_label":"Preventie","professions":["apotheker","cardioloog"],"tags":["aspirine"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaf680","source_url":"https://doi.org/10.1093/eurheartj/ehaf680","authors":["Jean-Guillaume Dillinger","Théo Pezel","Laure Batias","Denis Angoulvant","Marc Goralski","Emile Ferrari","Guillaume Cayla","Johanne Silvain","Martine Gilard","Gilles Lemesle","Géraud Souteyrand","Pascal Lim","François Roubille","Jean-Louis Georges","Claire Bal Dit Sollier","Thibaut Petroni","Olivier Morel","Nicolas Delarche","Meier Elbaz","Etienne Puymirat","Solenn Toupin","Gilles Montalescot","Ludovic Drouet","Eric Vicaut","Patrick Henry"],"significance":6,"published":"2026-02-11","source_date":"2026-02-11","image":"","kennis":[],"congress":"","summary_en":"The ANDAMAN trial tested higher aspirin dosing in ACS patients with suspected aspirin resistance, evaluating whether dose escalation overcomes inadequate platelet inhibition in diabetes and high-risk patients.","created":"2026-07-03T10:32:11Z","updated":"2026-07-03T13:31:09Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De ANDAMAN-trial onderzocht hogere aspirinedosering bij ACS met verdenking aspirineresistentie. Het concept van aspirineresistentie en dosisaanpassing vereist meer bewijs.","abstract_original":"BACKGROUND AND AIMS: Despite current antithrombotic treatments, the recurrence of ischaemic events remains high in patients with diabetes mellitus (DM) or aspirin resistance after acute coronary syndrome (ACS). Whether twice-daily aspirin dosing reduces major adverse cardiovascular events (MACE) in this population remains unknown. METHODS: In this prospective multicentre, randomized trial, patients with ACS and DM or high-risk of aspirin resistance (HRAR) defined as: (i) an index event occurring while on aspirin; (ii) body mass index ≥27 kg/m2; or (iii) increased waist circumference were assigned to receive enteric-coated aspirin once daily (100 mg/day) or twice daily (100 mg morning and evening). The primary outcome was MACE, a composite of any death, myocardial infarction, stroke, urgent coronary revascularization, stent thrombosis, or acute arterial thrombotic event assessed using a time-to-first-event analysis. The main secondary outcome was major bleeding (Bleeding Academic Research Consortium type 3-5). RESULTS: In total, 2484 participants were enrolled (77.2% with DM, 55.5% with ST-elevation segment myocardial infarction). The median follow-up duration was 18 (interquartile range: 17.6-18.3) months. The primary outcome occurred in 95 of 1228 participants (7.7%) in the twice-daily aspirin group, and 110 of 1256 (8.8%) in the once-daily group (hazard ratio [HR] 0.90; 95% confidence interval [CI] 0.69-1.19; P = .42). Major bleeding rates were similar between the groups (1.9% vs 2.1%; HR 0.88; 95% CI 0.50-1.55). CONCLUSIONS: In patients with ACS and DM or HRAR, twice-daily aspirin did not significantly reduce the risk of MACE compared to once-daily dosing. No significant difference was observed in major bleeding between groups. TRIAL REGISTRATION: NCT02520921/EUDRACT No: 2015-000947-18."}