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European Heart Journal 1985 6(5):409-417;
Copyright © 1985 by the European Society of Cardiology.
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© 1985 The European Society of Cardiology

Low-dose aspirin in patients recovering from myocardial infarction. Evidence for a selective inhibition of thromboxane-related platelet function

R. DE CATERINA*,, D. GIANNESSI*, W. BERNINI*, P. GAZZETTI*, C. MICHELASSI*, A. L'ABBATE*, L. DONATO*, P. PATRIGNANl{dagger}, P. FlLABOZZl{dagger} and C. PATRONO{dagger}

*Division of Cardiology, C.N.R. Institute of Clinical Physiology and Istituto di Patologia Speciale Medica I, University of Pisa Pisa
{dagger}Department of Pharmacology and Centro di Studio per la Fisiopatologia dello Shock del C.N.R., Catholic University School of Medicine Roma, Italy

Received 12 September 1984; revised 13 February 1985; .

Raffaele De Caterina, M.D., Division of Hematology–Oncology, Cornell University Medical College, 1300 York Avenue, New York, N.Y. 10021, U.S.A.

Abstract

The adequacy, selectivity and long-term persistence of inhibition in cyclooxygenase-dependent platelet function by a daily low-dose (0.45 mg kg–1 day–1) aspirin treatment have been evaluated in 15 patients after a recent (less than 17 days) acute myocardial infarction. Serum thromboxane (TX) B2, an index of platelet TXA2 production, was decreased by 94–98% (P<0.001) by aspirin, while urinary excretion of 6-keto-prostaglandin Fla, as an index of extraplatelet cyclooxygenase activity, remained unchanged. Compared to placebo, aspirin induced a persistent increase in bleeding time (% difference 45.6±21.4, mean ± SD) and a decrease in platelet aggregation by ADP, epinephrine, collagen and arachidonic acid. No tendency towards an attenuation of the effects was apparent for the period of aspirin administration (4 weeks).

Aspirin 0.45 mg kg–1 day–1 is adequate and selective in the long-term inhibition of TX-related platelet function in patients after acute myocardial infarction. The clinical effectiveness of such a regimen remains to be proven in clinical trials.

Key Words: Aspirin • platelet function • thromboxane • prostacyclin


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