Why the study?
Synergistic platelet inhibiting effects of ASA and Omega-3 have been demonstrated with other methods, but whether multiple electrode aggregometry could detect these antiplatelet effects and synergism remained unknown.
Does Omega-3 combined with acetylsalicylic acid improve platelet inhibition in healthy male volunteers?
Does Omega-3 combined with acetylsalicylic acid improve platelet inhibition in healthy male volunteers?
The study found no synergistic platelet inhibition between Omega-3 and acetylsalicylic acid using multiple electrode aggregometry, suggesting potential methodological limitations of the assay.
Findings should not change antiplatelet practice; leaves open questions on Omega-3–ASA interactions and MEA reliability.
BACKGROUND: Omega-3 and acetylsalicylic acid (ASA) are two widely used "over-the-counter" drugs. Previous research has shown multiple electrode aggregometry (MEA) can detect ASA and varying Omega-3 platelet inhibiting effects. Synergistic platelet inhibiting effects of ASA and Omega-3 have been found using other methods than MEA. The aim of this study was to investigate the antiplatelet effects of Omega-3, and ASA synergism with MEA. METHODS: Ten healthy male volunteers ingested Omega-3 (1260 mg/day) for 5 days. MEA was used to analyse platelet function before and after Omega-3 intake. Aggregation was initiated using three different agonists and measured as area under the curve (AUC): adenosine diphosphate (ADP), thrombin receptor activating peptide (TRAP) and arachidonic acid (ASPI). Two concentrations of ASA were dose titrated ex vivo to 2 out of 3 ASPI test cells in order to measure synergism between Omega-3 and ASA. RESULTS: Following 5 days Omega-3 intake, ADP, TRAP and ASPI AUC did not change significantly. In vitro ASA before Omega-3 intake, reduced ASPI AUC < 30 U, indicating a strong platelet inhibiting effect. Below this AUC level, the 5 days Omega-3 intake increased ASPI-AUC with the ex vivo added low dose ASA (P = 0.02) and high dose ASA (P = 0.04). CONCLUSIONS: No synergism between ASA and Omega-3 was found using the MEA ASPI test. The surprising increase in ASPI-AUC following Omega-3 intake and ex vivo ASA suggest that there are methodological issuses with the MEA ASPI test. TRIAL REGISTRATION: Trial registration ISRCTN78027929 . Registered 19 May 2015.
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Bagger et al. (2020) studied this question.
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