Assessment of Common Nonsteroidal Anti-Inflammatory Medications by Whole Blood Aggregometry: A Clinical Evaluation for the Perioperative Setting

William W. Scott, Michael Levy, Kim L. Rickert, Christopher J. Madden, Joseph E. Beshay, Ravi Sarode

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective: To help define the perioperative risk related to commonly used non-aspirin NSAIDs with whole blood platelet aggregometry. Methods: Twelve healthy volunteers were recruited. Two cyclooxygenase (COX)-1 inhibitors (ibuprofen and naproxen) and two COX-2 inhibitors (meloxicam and celecoxib) were administered, and daily whole blood platelet aggregometry studies were obtained until studies showed no platelet inhibition. Aspirin was studied at the conclusion of the study. Results: Ibuprofen had no inhibitory effect on platelet aggregation in all women and no inhibitory effect in 83% of men at 24 hours. All platelet function had returned to normal at 48 hours. The inhibitory effect of naproxen on platelets was absent at 48 hours in 83% of the women and 50% of men. By 72 hours all platelet studies had returned to normal. Meloxicam and celecoxib did not cause any overall inhibitory effect on platelet aggregation. Conclusions: Ibuprofen and naproxen have a mild inhibitory effect on platelet aggregation compared with aspirin and this effect is undetectable by 48 hours and 72 hours, respectively. Meloxicam and celecoxib show essentially no inhibitory effect on platelet aggregation. These findings suggest that there is little bleeding risk related to platelet aggregation at 24 hours in patients who take COX-2 inhibitors and at 72 hours for those who take COX-1 inhibitor medications.

Original languageEnglish (US)
JournalWorld Neurosurgery
DOIs
StateAccepted/In press - 2014

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meloxicam
Celecoxib
Platelet Aggregation
Anti-Inflammatory Agents
Blood Platelets
Naproxen
Ibuprofen
Cyclooxygenase 1
Cyclooxygenase Inhibitors
Cyclooxygenase 2 Inhibitors
Aspirin
Non-Steroidal Anti-Inflammatory Agents
Healthy Volunteers
Hemorrhage

Keywords

  • COX-1 inhibitor
  • COX-2 inhibitor
  • Nonsteroidal anti-inflammatory
  • Perioperative risk
  • Surgical bleeding
  • Whole blood platelet aggregometry

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

@article{152c2ca089af49bd9037b0f23a46f39c,
title = "Assessment of Common Nonsteroidal Anti-Inflammatory Medications by Whole Blood Aggregometry: A Clinical Evaluation for the Perioperative Setting",
abstract = "Objective: To help define the perioperative risk related to commonly used non-aspirin NSAIDs with whole blood platelet aggregometry. Methods: Twelve healthy volunteers were recruited. Two cyclooxygenase (COX)-1 inhibitors (ibuprofen and naproxen) and two COX-2 inhibitors (meloxicam and celecoxib) were administered, and daily whole blood platelet aggregometry studies were obtained until studies showed no platelet inhibition. Aspirin was studied at the conclusion of the study. Results: Ibuprofen had no inhibitory effect on platelet aggregation in all women and no inhibitory effect in 83{\%} of men at 24 hours. All platelet function had returned to normal at 48 hours. The inhibitory effect of naproxen on platelets was absent at 48 hours in 83{\%} of the women and 50{\%} of men. By 72 hours all platelet studies had returned to normal. Meloxicam and celecoxib did not cause any overall inhibitory effect on platelet aggregation. Conclusions: Ibuprofen and naproxen have a mild inhibitory effect on platelet aggregation compared with aspirin and this effect is undetectable by 48 hours and 72 hours, respectively. Meloxicam and celecoxib show essentially no inhibitory effect on platelet aggregation. These findings suggest that there is little bleeding risk related to platelet aggregation at 24 hours in patients who take COX-2 inhibitors and at 72 hours for those who take COX-1 inhibitor medications.",
keywords = "COX-1 inhibitor, COX-2 inhibitor, Nonsteroidal anti-inflammatory, Perioperative risk, Surgical bleeding, Whole blood platelet aggregometry",
author = "Scott, {William W.} and Michael Levy and Rickert, {Kim L.} and Madden, {Christopher J.} and Beshay, {Joseph E.} and Ravi Sarode",
year = "2014",
doi = "10.1016/j.wneu.2014.03.043",
language = "English (US)",
journal = "World Neurosurgery",
issn = "1878-8750",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Assessment of Common Nonsteroidal Anti-Inflammatory Medications by Whole Blood Aggregometry

T2 - A Clinical Evaluation for the Perioperative Setting

AU - Scott, William W.

AU - Levy, Michael

AU - Rickert, Kim L.

AU - Madden, Christopher J.

AU - Beshay, Joseph E.

AU - Sarode, Ravi

PY - 2014

Y1 - 2014

N2 - Objective: To help define the perioperative risk related to commonly used non-aspirin NSAIDs with whole blood platelet aggregometry. Methods: Twelve healthy volunteers were recruited. Two cyclooxygenase (COX)-1 inhibitors (ibuprofen and naproxen) and two COX-2 inhibitors (meloxicam and celecoxib) were administered, and daily whole blood platelet aggregometry studies were obtained until studies showed no platelet inhibition. Aspirin was studied at the conclusion of the study. Results: Ibuprofen had no inhibitory effect on platelet aggregation in all women and no inhibitory effect in 83% of men at 24 hours. All platelet function had returned to normal at 48 hours. The inhibitory effect of naproxen on platelets was absent at 48 hours in 83% of the women and 50% of men. By 72 hours all platelet studies had returned to normal. Meloxicam and celecoxib did not cause any overall inhibitory effect on platelet aggregation. Conclusions: Ibuprofen and naproxen have a mild inhibitory effect on platelet aggregation compared with aspirin and this effect is undetectable by 48 hours and 72 hours, respectively. Meloxicam and celecoxib show essentially no inhibitory effect on platelet aggregation. These findings suggest that there is little bleeding risk related to platelet aggregation at 24 hours in patients who take COX-2 inhibitors and at 72 hours for those who take COX-1 inhibitor medications.

AB - Objective: To help define the perioperative risk related to commonly used non-aspirin NSAIDs with whole blood platelet aggregometry. Methods: Twelve healthy volunteers were recruited. Two cyclooxygenase (COX)-1 inhibitors (ibuprofen and naproxen) and two COX-2 inhibitors (meloxicam and celecoxib) were administered, and daily whole blood platelet aggregometry studies were obtained until studies showed no platelet inhibition. Aspirin was studied at the conclusion of the study. Results: Ibuprofen had no inhibitory effect on platelet aggregation in all women and no inhibitory effect in 83% of men at 24 hours. All platelet function had returned to normal at 48 hours. The inhibitory effect of naproxen on platelets was absent at 48 hours in 83% of the women and 50% of men. By 72 hours all platelet studies had returned to normal. Meloxicam and celecoxib did not cause any overall inhibitory effect on platelet aggregation. Conclusions: Ibuprofen and naproxen have a mild inhibitory effect on platelet aggregation compared with aspirin and this effect is undetectable by 48 hours and 72 hours, respectively. Meloxicam and celecoxib show essentially no inhibitory effect on platelet aggregation. These findings suggest that there is little bleeding risk related to platelet aggregation at 24 hours in patients who take COX-2 inhibitors and at 72 hours for those who take COX-1 inhibitor medications.

KW - COX-1 inhibitor

KW - COX-2 inhibitor

KW - Nonsteroidal anti-inflammatory

KW - Perioperative risk

KW - Surgical bleeding

KW - Whole blood platelet aggregometry

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