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Variability of the antithrombotic effect of acetylsalicylic acid with the administration of different dosages: reality or myth?
Session:
Comunicações Orais - Sessão 16 - Ciência Básica
Speaker:
Joana Lima Lopes
Congress:
CPC 2023
Topic:
O. Basic Science
Theme:
36. Basic Science
Subtheme:
36.6 Basic Science - Other
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Joana Lima Lopes; Mariana Passos; Carolina Mateus; Inês Fialho; Vanessa de Oliveira; Diana Sousa Mendes; David Roque
Abstract
<p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Introduction</strong>: We rely on the antithrombotic effect of acetylsalicylic acid (ASA) in a number of pathologies, although other beneficial effects are known, such as its anti-inflammatory properties, when administered in higher doses (500mg, 1000mg per os). However, whether the anti-inflammatory effect decreases the antithrombotic potency of ASA is not known. This gap in evidence may lead to an unnecessary use of two drugs (one antithrombotic and one anti-inflammatory) that could be replaced by ASA alone. This scenario presents frequently: post-infarct pericarditis or when in doubt between non-ST segment elevation myocardial infarction <em>vs</em>myopericarditis. In such cases, the use of ASA could assure both antithrombotic and anti-inflammatory effects. Since the antithrombotic effect of ASA is not scientifically proved for higher doses, currently we use ASA 100mg as an antithrombotic agent and ibuprofen as an anti-inflammatory. This experimental study intends to assess whether ASA maintains its antithrombotic effect when administered in an anti-inflammatory dose. </span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Methods: </strong>Twenty healthy volunteers were recruited. They all had their platelet function assessed in a qualitative manner, using <em>PFA-200 Innovance</em>technology. The volunteers were randomized into four groups, with 5 participants each. The participants of <strong>groups 1, 2, 3 and 4</strong>ingested ASA 100mg, 300mg, 500mg and 1000mg respectively, in a blind experiment. One hour after ingestion (peak of action), the volunteers’ platelet function was reassessed.<em>PFA-200</em>evaluates platelet function through platelet occlusion time (OT), which is measured in milliseconds (ms). Normal platelet function translates into OT of 82-150ms. If the OT is higher than 150ms, the patient is anti-aggregated.</span></span></span></p> <p style="text-align:justify"><span style="font-size:medium"><span style="font-family:Calibri,sans-serif"><span style="color:#000000"><strong>Results: </strong>Prior to ASA administration, 19/20 volunteers had OT within the reference range. Afterwards, in all four groups, volunteers reached OT > 150ms, regardless of the ASA dose administered. Mean OT values for each group were 188ms [SD-23] , 205ms [SD-63], 262ms[SD-44] and 232ms [SD-47], respectively. Overall SD was 32ms. </span></span></span></p> <p><strong><span style="font-size:12pt"><span style="font-family:Calibri,sans-serif">Conclusion: </span></span></strong><span style="font-size:12pt"><span style="color:#000000"><span style="font-family:Calibri,sans-serif">ASA maintains its antithrombotic effect when administered in an anti-inflammatory dose.There is no clear correlation between the potency of antithrombotic effect and the ASA dose administered. This was a pilot study that supports the maintenance of the antithrombotic effect of ASA in higher doses, but further and larger studies are required to corroborate these results. </span></span></span></p>
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