Intake of aspirin prior to metamizole does not completely prevent high on treatment platelet reactivity View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2020-01-08

AUTHORS

Christian Pfrepper, Carolin Dietze, Yvonne Remane, Thilo Bertsche, Susanne Schiek, Thorsten Kaiser, Ines Gockel, Christoph Josten, Sirak Petros

ABSTRACT

PurposeMetamizole can sterically inhibit aspirin (ASA) from binding to cyclooxygenase 1 (COX1). It is recommended that ASA should be taken 30 min prior to metamizole to maintain the irreversible inhibition of arachidonic acid (AA)–induced platelet aggregation. We aimed to analyse the inhibitory effect of ASA and metamizole on AA-induced platelet aggregation over the course of the day.MethodsWe analysed hospitalized patients who ingested ASA at least 30 min prior to metamizole (recommended dosing group, n = 15), metamizole prior or simultaneously with ASA (not recommended dosing group, n = 16) and patients with unknown or mixed intake (mixed dosing group, n = 5). AA-induced light transmission (LTA) and impedance aggregometry (IA) were measured before, 1–2 and 5–6 h after the intake of ASA ± metamizole.ResultsMaximum AA-induced LTA prior to the intake of ASA was significantly lower and the rate of high on treatment platelet reactivity (HTPR) higher in the recommended compared with the not recommended dosing group (19.6% vs. 46.9%, p = 0.011 and 4/15 vs. 12/16 patients, p = 0.017). There was no difference when IA was used. Maximum AA-induced LTA after the intake of ASA ± metamizole was lower in patients in the not recommended but not in the recommended dosing group. All patients with HTPR in the recommended dosing group had regular inhibition of AA-induced LTA after discontinuation of metamizole.ConclusionCo-medication of ASA and metamizole significantly influences platelet inhibition with variations during the day and can cause HTPR in patients taking ASA prior to metamizole or simultaneously. More... »

PAGES

483-490

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00228-019-02791-1

DOI

http://dx.doi.org/10.1007/s00228-019-02791-1

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1123954032

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31915847


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