Do patients with epistaxis have drug-induced platelet dysfunction?
Aspirin and other non-steroidal anti-inflammatory drugs (NSAID) are being used increasingly. A positive correlation has been shown between epistaxis and the use of NSAID in the over 50s. This prospective study compared the NSAID intake and platelet function in 50 patients with epistaxis and 50 controls. Standard haematological parameters and the platelet response to collagen and arachidonic acid aggregation and adenosine triphosphate release were measured. The patients showed a significant increase in NSAID intake (P < 0.01, 95% confidence for the difference in the medians = 4-36%) and hypertension (for diastolic blood pressure > 100 mmHg, P < 0.01, 95% confidence for the difference in the medians = 5.9-16.1). The patients showed a significant reduction in platelet aggregation to collagen (P = 0.025). Non-steroidal anti-inflammatory drugs produce a significant platelet dysfunction which should be considered in the multifactorial aetiology of epistaxis.
Livesey
J R
JR
Department of Otolaryngology, Freeman Hospital, Newcastle-upon-Tyne, UK.
Watson
M G
MG
Kelly
P J
PJ
Kesteven
P J
PJ
D000255:Adenosine Triphosphate / Q000378:metabolism; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D001095:Arachidonic Acids / Q000494:pharmacology; D001241:Aspirin / Q000009:adverse effects; D001791:Blood Platelet Disorders / Q000139:chemically induced*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism; D002425:Cautery; D003094:Collagen / Q000494:pharmacology; D004844:Epistaxis / Q000139:chemically induced* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology; D011446:Prospective Studies; D012835:Silver Nitrate / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001095:Arachidonic Acids; D010975:Platelet Aggregation Inhibitors; D000255:Adenosine Triphosphate; D003094:Collagen; D012835:Silver Nitrate; D001241:Aspirin