Dosing frequency may also be open to optimization. Aspirin is cleared from the plasma quickly after administration but its effect lasts for the lifespan of a platelet due to its properties as an irreversible inhibitor (Patrono 1994). However, a significant proportion of the population have a high rate of platelet turnover that therefore reduces the duration of effect and may lead to inadequate platelet inhibition. This has been shown to be the case in patients with ischaemic heart disease and is most frequently a problem in those with diabetes mellitus, obesity and smokers (Henry, Vermillet et al. 2011). Twice-daily dosing may offer more consistency (Rocca, Santilli et al. 2012, Paikin, Hirsh et al. 2015). Again, this has not been studied when in combination with a P2Y12 inhibitor. As ticagrelor is taken twice daily, it would not significantly inconvenience patients to receive doses of aspirin in this way.