AJM OnlineClinical research studyParadoxical Rebound Platelet Activation After Painkillers Cessation: Missing Risk for Vascular Events?
Section snippets
Subjects
Subjects were eligible if they met all of the following inclusion criteria: males and females 21 years and older; able to provide informed consent; documented history of vascular disease, or more than 2 of 8 risk factors for vascular disease (family history, sedentary lifestyle, diabetes mellitus, hypertension, morbid obesity, hypercholesterolemia, postmenopausal or surgically sterile females, current or recent smokers); and available and willing to return for follow-up tests. Subjects were
Results
A total of 180 volunteers were initially considered, but 8 participants had to be excluded from analysis because of clots in the samples (1 participant), baseline cell counts out of institutional limits (2 participants), use of aspirin (4 participants), and noncompliance (1 participant). The remaining 172 aspirin-naive subjects were considered evaluable and grouped into the dataset with complete aggregometry, analyzer, and receptor measures dependent on NSAID and COX-2 inhibitor use. The locked
Discussion
The data from the present retrospective analyses are the first to suggest that it is not immediate therapy with NSAIDs and COX-2 inhibitors, but rather withdrawal from these agents that is associated with a paradoxical increase of platelet activity. Despite the obvious limitations of this study, these findings may provide some insights into the existing and growing concern that NSAIDs and COX-2 inhibitors may be associated with worse clinical outcomes. Most important, if such vascular events
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