Platelet function recovery after cessation of aspirin: preliminary study of volunteers and surgical patients

Abstract

Platelet aggregometry with arachidonic acid is a sensitive test for the evaluation of the effects of aspirin on platelet function. In most aspirin-treated patients, platelet function recovers 4 days after drug cessation, although the process is sometimes prolonged. Therefore, the time of aspirin cessation before scheduled surgery should be determined individually.

Interventional Spine and Pain Procedures in Patients on Antiplatelet and Anticoagulant Medications

“…Another study examining platelet functional recovery after cessation of aspirin in volunteers and surgical patients demonstrated that most of the volunteers and patients experienced recovery of platelet function at day 3 and within 4 to 6 days, respectively. 106 By day 6, all of the subjects had restored platelet aggregation to at least 85% of baseline level. Also, studies examining the effect of aspirin on platelet aggregation in cardiac surgery patients demonstrate earlier platelet recovery, as early as 3 days postdiscontinuation.…”

“…◯ When aspirin is being used for primary prophylaxis, aspirin may be discontinued for a longer period, 6 days, to ensure complete platelet functional recovery. 106 • In individuals using aspirin for secondary prophylaxis undergoing high-risk procedures, a shared assessment, risk stratification, and management decision should involve the interventional pain physician, patient, and physician prescribing aspirin. The risk of bleeding while continuing aspirin needs to be weighed against the cardiovascular risks of stopping aspirin.…”

“…◯ When performing elective pain procedures where there is either a high risk (Table 1) of potential bleeding and/or the possibility of significant sequelae in an individual taking aspirin for secondary prophylaxis, aspirin should be discontinued for a minimum of 6 days. 106 In individuals taking aspirin for secondary prophylaxis who are undergoing low-or medium-risk procedures for which a decision has been made to discontinue, the length of discontinuation can be shortened to 4 days in an effort to balance the risks of procedural bleeding and cardiovascular events. 40, 106 Zisman et al 106 demonstrated that in most aspirin-treated patients, platelet function recovers 4 days after drug discontinuation.…”

Postoperative Hemostasis Monitoring and Management

“…71 Platelet aggregometry evaluated in patients after discontinuation of aspirin therapy has found variability in the time required for recovery of adequate platelet function, with longer time required for patients receiving clopidogrel. [105][106][107] Therefore, continuation of antiplatelet therapy is reserved for patients at high risk of thrombosis, with interruption of drug therapy 2 to 3 half-lives before minor surgery, and 4 to 5 halflives before major surgery (using the upper limit of the half-life in calculating this time). 108 Otherwise, discontinuation 7 to 10 days preoperatively is recommended.…”

Shockwave Lithotripsy: Arterial Aneurysms and Vascular Complications

“…In those cases where it is appropriate, aspirin therapy should be ceased 4 days before SWL because platelet function is restored in most patients by this time. 66 Patients receiving clopidogrel should stop use 7 days before SWL; in healthy subjects, a once daily dose of 75 mg of clopidogrel can be reversed with recovery of platelet function in this time frame. 67 Warfarin is a coumarin derivative and is the most commonly used anticoagulant for treatment of thromboembolic disorders and for patients with metallic heart valves.…”