Stroke, Vol 23, 1400-1403, Copyright © 1992 by American Heart Association
H Tohgi, S Konno, K Tamura, B Kimura and K Kawano
BACKGROUND AND PURPOSE: The purpose of this study was to compare the
effects of low-to-high doses of aspirin on platelet aggregability
determined by different methods and on the metabolism of thromboxane A2 and
prostacyclin. METHODS: We administered increasing doses (40, 320, and 1,280
mg/day) of aspirin to 19 poststroke patients and studied the differences in
1) the changes in platelet aggregability depending on the methods of
evaluation and 2) the concentrations of prostaglandin metabolites in the
blood and urine. RESULTS: Aggregation of platelet- rich plasma induced by a
strong stimulus (10 microM ADP) was significantly reduced after 40 mg/day
aspirin (p less than 0.005), and this reduction was similar to that after
higher aspirin doses. In contrast, aggregation of platelet-rich plasma
induced by weaker stimuli (1 and 5 microM ADP) decreased less significantly
after 40 mg/day aspirin compared with that after higher aspirin doses. The
serum thromboxane B2 generated after ex vivo incubation was reduced
significantly (by 85%) after 40 mg/day aspirin and decreased further after
320 mg/day (by 96%) and 1,280 mg/day (by greater than 99%) of aspirin. The
urinary 11-dehydro-thromboxane B2 concentration decreased less
significantly after 40 mg/day aspirin (by 42%) compared with that after 320
mg/day (by 78%) and 1,280 mg/day (by 91%) aspirin doses. The urinary
concentration of 2,3-dinor-6-keto-prostaglandin F1 alpha did not decrease
after 40 mg/day aspirin but decreased significantly after higher doses of
aspirin. CONCLUSIONS: These findings suggest that different doses of
aspirin may be necessary to prevent thrombogenesis induced by different
triggers of different strengths and that 40 mg/day aspirin is able to
inhibit a large proportion of maximum thromboxane A2 release provoked
acutely, with the prostaglandin I2 synthesis being little affected;
however, higher doses of aspirin are required to attain further inhibition.
ARTICLES
Effects of low-to-high doses of aspirin on platelet aggregability and metabolites of thromboxane A2 and prostacyclin
Department of Neurology, Iwate Medical University, Morioka, Japan.
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