Experience with Aspirin-Dipyridamole Prophylaxis in Sickle Cell Disease

Abstract

Crisis in sickle cell disease (SSD) patients is associated with reproducible sequential hemostatic changes indicative of intravascular fibrin formation and marked disturbance of platelet economy. With crisis onset, plasma high molecular weight fibrin(ogen) complexes are elevated and there is a transient fall in platelets. Subsequently fibrinogen and platelet counts rise, reaching their peaks respectively one and two weeks alter onset. Three SSD patients have been followed by weekly clinical and laboratory examinations for a two year control and a two year prophylactic treatment period (aspirin 650 mg, dipyridamole 50 mg b.d.). Patient symptomatic status was classified weekly as 1 (asymptomatic) through 4 (hospitalized). Increase in fibrinogen concentration was significantly correlated with patient disease status. While on treatment, the patients were asymptomatic or mildly symptomatic for 85% of the time compared to 73% of the control time.Analysis of the clinical status data (2 × n Chi square) showed a statistically significant difference in favor of the treatment (p < 0.0l) and the time spent in hospital was significantly reduced during treatment (p < 0.02).

Platelet hyperactivity in sickle-cell disease: a consequence of hyposplenism.

“…There is, however, one report of aspirindipyridamole prophylaxis causing a small reduction in symptomatic episodes in three patients. 10 The present study was designed to examine platelet function during the steady state in comparison with healthy controls and splenectomised patients.…”