What is the role of aspirin in TTP treatment?

• A. Aspirin acts as a platelet inhibitor to prevent further clotting.
• B. Aspirin increases platelet production.
• C. Aspirin dissolves clots by enzymatic activity.
• D. Aspirin substitutes missing clotting factors.

Answer: (A)

Aspirin works here by acting as a platelet inhibitor to prevent further platelet aggregation. In TTP, small-vessel thrombi form because ultra-large von Willebrand factor multimers promote platelet sticking together with circulating platelets. By irreversibly inhibiting cyclooxygenase-1 in platelets, aspirin reduces thromboxane A2 production, dampening platelet activation and helping to limit the growth of these microthrombi. This antiplatelet effect can be useful as an adjunct after the acute phase when platelet counts are rising, though the main treatment remains plasma exchange and immunosuppression. Aspirin does not increase platelet production, dissolve clots enzymatically, or replace missing clotting factors.