Magnitude and time course of impaired primary haemostasis after stopping chronic low and medium dose aspirin in healthy volunteers

Abstract

Aspirin ingestion within the previous 7-10 days is often considered a relative contraindication to performing invasive procedures. However, aspirin is an important component of many patients' treatment and withholding therapy for this time may be dangerous. To measure both the magnitude of the impairment in primary haemostasis induced by aspirin and how much recovery of platelet function occurs within 48 h of stopping aspirin, we studied serial changes in bleeding time (BT) in a randomized, double-blind, placebo-controlled study. Fifty-two healthy volunteers had BT performed before and at 2, 9, 24 and 48 h after a 7-day course of either aspirin 75 mg, 300 mg or placebo. The main outcome recorded was BT at each time. Nearly 25% of subjects had extended BT to more than 10 min, but no BT were greater than 10 min, 48 h after stopping aspirin. There was a small but statistically significant (P < 0.01) difference between the 48-h and baseline BT in both aspirin groups (49 and 64 s in the 75 mg and 300 mg groups, respectively). There was no difference in the magnitude or time course of effect between low and medium dose aspirin (P = 0.392 and P = 0.797, respectively). We conclude that despite considerable inter-individual variability in the magnitude of aspirin effect on primary haemostasis, the time course of effect was consistent. In healthy volunteers, the defect in primary haemostasis had largely disappeared 48 h after the last dose.

Incidence and outcome of surgical procedures after sirolimus-eluting stent implantation: a report from the j-Cypher registry

“…When discontinuation was unavoidable, it seems practically important to make the duration of discontinuation as short as possible, since the majority of ST events were reported to have occurred beyond 1 week after discontinuation of APT [11]. Since bleeding time was reported to recover to the baseline level after 3-5 days of aspirin cessation, discontinuation of aspirin 3-5 days before surgical procedures would be long enough to minimize bleeding risk when discontinuation of aspirin is unavoidable [24,25].…”

Study for determination of the optimal cessation period of therapy with anti-platelet agents prior to invasive endoscopic procedures

“…36,37 However, considering the risk of thromboembolism, there are reports that a shorter cessation period may be sufficient. 13,15 Some reports have evaluated hemostasis after the stopping of ASA; 12,14,38 however, there are few such reports on TP or combined therapy. 12,39 We studied the effect of ASA, TP, and a combination regimen on primary hemostasis in healthy volunteers.…”

“…9,10 Only a few studies have actually studied whether here should be a cessation period, and if so, its optimal duration, for various anti-platelet agents prior to endoscopic procedures. [11][12][13][14][15] In order to minimize the risk of bleeding complications due to the administration of anti-platelet agents versus the risk of thromboembolism due to the cessaBackground. Anti-platelet agents are widely used for the treatment and prevention of thrombotic diseases.…”

Assessment of Effects of Antiplatelet Drugs on Bleeding Risk After Teeth Extractions

“…Because of the wide variability and lack of specificity of this test, its use in the detection of blood dyscrasia is limited. nevertheless, Bt test remains useful in the preoperative assessment of patients with haemostatic disorders (21). in the present study, Bt was examined preoperatively.…”

“…An association between the use of ASA and bleeding outcome measures was not identified. Moreover, Sonksen, et al showed that the increase in Bt caused by daily ASA in doses of up to 300 mg did not exceed normal limits in most patients (21). thus, patients need not to stop taking ASA before dental surgery, as the hemorrhagic risk is not greater than the thromboembolic risk associated with interruption of the drug regimen.…”