Variability of Platelet Function Response to Aspirin

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Abstract
To evaluate the effect of aspirin on platelet function, three groups of subjects were studied. Platelet adhesiveness (pl. adh.) was determined by the Hellem glass bead retention method, and platelet aggregation (pi. agg.) by the Born turbidimetric method using standardized collagen of various dilution. In eight healthy volunteers, the mean pl. adh. decreased insignificantly from 45% ± 13 to 41% ± 13 after 5-7 days of 600 mg/day of aspirin. They showed slight to moderate impairment of platelet aggregation. In 16 patients with massive gastrointestinal bleeding, following ingestion of aspirin, the mean pl. adh. was 22% ± 5 which is significantly lower (P<0.01) than for the normal individuals. These patients showed poor to no platelet aggregation. By contrast in 14 patients with rheumatoid arthritis, despite being on large doses of aspirin, the mean pl. adh. was 61% ± 15 which is significantly higher (P<0.05) than for the non-arthritics. In six.: of these patients pl. agg. was also measured. They showed no or slight impairment. These observations provide a plausible explanation for the conflicting reports regarding efficacy and complications of aspirin and emphasize the need to differentiate between its anti-inflammatory and antithrombogenic effects by actual determination of platelet function in patients treated with aspirin.

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