Acetylsalicylic acid, diclofenac, and lornoxicam, but not rofecoxib, affect platelet CD 62 expression.
Nonsteroidal antiinflammatory drugs are routinely administered in the perioperative period. Because of the absence of cyclooxygenase-2 in platelets, cyclooxygenase-2-selective drugs are thought not to cause platelet inhibition. Because platelets play an important role in the coagulation process, the absence of platelet function inhibition may lead to fewer bleeding complications after surgery. We studied the influence of aspirin, diclofenac, lornoxicam, and rofecoxib on arachidonic acid and collagen-induced CD 62 P (P selectin) expression by using flow cytometry. Blood from 68 volunteers was obtained before and 1, 3, and 12 h after the oral ingestion of 1 of the randomly assigned study medications. Aspirin, diclofenac, and lornoxicam had a significant effect on arachidonic acid and collagen-induced CD 62 P expression in platelets, whereas rofecoxib did not show this effect. We conclude that rofecoxib is safe to use perioperatively with respect to inhibition of platelet function.


CONCLUSIONS
We compared the effect of rofecoxib and three nonselective nonsteroidal antiinflammatory drugs on platelet function, measured by CD 62 P expression. Platelet function was not altered by rofecoxib, but it was inhibited by aspirin, diclofenac, and lornoxicam. Rofecoxib may be safer than classic NSAIDs with respect to platelet function during the perioperative period.
Blaicher
Alex M
AM
*Department of Anesthesiology and General Intensive Care, University of Vienna; †Ludwig Boltzmann Institute of Clinical Anesthesiology and Intensive Care; ‡Institute of Medical Physiology, University of Vienna; and §Department of Medical Statistics, University of Vienna, Vienna, Austria.
Landsteiner
Harald T
HT
Al-Falaki
Olga
O
Zwerina
Jochen
J
Volf
Ivo
I
Gruber
Diego
D
Zimpfer
Michael
M
Hoerauf
Klaus
K
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D016718:Arachidonic Acid / Q000494:pharmacology; D001241:Aspirin / Q000009:adverse effects*; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D003094:Collagen / Q000494:pharmacology; D051546:Cyclooxygenase 2; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors / Q000009:adverse effects*; D004008:Diclofenac / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D007783:Lactones / Q000009:adverse effects*; D008297:Male; D008565:Membrane Proteins; D010894:Piroxicam / Q000009:adverse effects* / Q000031:analogs & derivatives*; D010979:Platelet Function Tests; D011446:Prospective Studies; D011451:Prostaglandin-Endoperoxide Synthases / Q000378:metabolism; D019087:Selectins / Q000096:biosynthesis*; D013450:Sulfones
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D016861:Cyclooxygenase Inhibitors; D007527:Isoenzymes; D007783:Lactones; D008565:Membrane Proteins; D019087:Selectins; D013450:Sulfones; C116926:rofecoxib; D010894:Piroxicam; D004008:Diclofenac; D016718:Arachidonic Acid; D003094:Collagen; D051546:Cyclooxygenase 2; C496540:PTGS2 protein, human; D011451:Prostaglandin-Endoperoxide Synthases; C059451:lornoxicam; D001241:Aspirin