What question did this study set out to answer?

To determine whether discontinuation of long-term acetylsalicylic acid therapy leads to rebound platelet activation and changes in bleeding time in patients with angina pectoris.

January 1, 1996Blood Coagulation & Fibrinolysis

Abnormally high platelet activity after discontinuation of acetylsalicylic acid treatment

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Why the study?

Does withdrawal of acetylsalicylic acid increase platelet activity and decrease bleeding time in men with angina pectoris?

Population

32 males (age 42-77 years) with angina pectoris on acetylsalicylic acid treatment

Comparison

Withdrawal of acetylsalicylic acid vs Baseline (during acetylsalicylic acid treatment)

Design

Cohort

Follow-up

2 weeks

Authors

HBH. BevingKarolinska University Hospital CZChunyu ZhaoEmory Healthcare TITorbjörn IvertCardiac Surgery

Discussion

Member takes

Implication

ASA withdrawal linked to rebound platelet activation in angina; hypothesis-generating for thrombotic risk, needs confirmation before practice change.

Key Points

To determine whether discontinuation of long-term acetylsalicylic acid therapy leads to rebound platelet activation and changes in bleeding time in patients with angina pectoris.
Prospective study of 32 male patients aged 42–77 years receiving acetylsalicylic acid (ASA) for angina pectoris at daily baseline doses of 75 mg (n = 15), 160 mg (n = 12), or 250–300 mg (n = 5).
Measured platelet production of 12-L-hydroxy-5,8,10-heptadecatrienoic acid (12-HHT), an equimolar marker of thromboxane A2, and template bleeding time during ASA therapy and at 1 and 2 weeks post-cessation.
At 1 week post-withdrawal, median 12-HHT increased from 40 to 240 g/750 × 10^6 platelets (P < 0.001), while median bleeding time decreased from 312 to 268 s (P = 0.003) in the 75 mg group and from 315 to 235 s (P = 0.01) in the 160 mg group.
At 2 weeks post-withdrawal, median 12-HHT rose further to 390 g/750 × 10^6 platelets, with 8 patients (25%) reaching abnormally elevated values, alongside wide interindividual variations across all dosage groups.

Structured PICO

Does withdrawal of acetylsalicylic acid increase platelet activity and decrease bleeding time in men with angina pectoris?

Population

32 males (age 42-77 years) with angina pectoris on acetylsalicylic acid treatment

Intervention

Withdrawal of acetylsalicylic acid (initial daily doses of 75 mg, 160 mg, or 250-300 mg)

Comparator

Baseline (during acetylsalicylic acid treatment)

Outcome

Production of 12-L-hydroxy-5, 8, 10-heptadecatrienoic acid (12-HHT) from platelets and bleeding times at 1 and 2 weeks after withdrawalsurrogate

Rapid withdrawal of acetylsalicylic acid in patients with angina pectoris leads to a significant rebound increase in platelet activity, potentially increasing the risk of adverse cardiovascular events.

Cite This Study

Beving et al. (1996) studied this question.

synapsesocial.com/papers/6a867c8ea0f68bd200d09ded https://doi.org/10.1097/00001721-199601000-00010

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Implication

ASA withdrawal linked to rebound platelet activation in angina; hypothesis-generating for thrombotic risk, needs confirmation before practice change.

Abnormally high platelet activity after discontinuation of acetylsalicylic acid treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Abnormally high platelet activity after discontinuation of acetylsalicylic acid treatment

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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