title: The effects of nonsteroidal anti-inflammatory drugs on platelet function and severity of upper gastrointestinal haemorrhage.
abstract: Nonsteroidal anti-inflammatory drugs (NSAIDs) cause gastrointestinal (GI) damage primarily due to the inhibition of prostaglandin synthesis in gastric mucosa, which is an important factor in mucosa protection. Platelets are a cardinal feature of vascular repair. A variety of angiogenic stimulators are stored in platelets and are released during clotting at the wound. When there is a defect in any of these functions and/or platelet number, haemostasis is usually impaired and there may be an associated increased risk and severity of bleeding. While the mechanism of mucosal injury and bleeding are well documented with the use of NSAIDs, very little is known about the platelet function abnormalities and their effects on severity of upper GI bleedings. We performed a prospective analysis of 49 patients who had a history of NSAIDs use to investigate the association between the platelet function impairment associated with NSAIDs and severity of upper GI haemorrhages. Thirty-six of 49 patients (73.5%) had deteriorated platelet function. Mean severity score of patients with deteriorated platelet functions was 3.39, and that of patients with normal platelet functions was 2.46. Mean severity score was statistically significantly higher in patients with deteriorated platelet functions. In conclusion, impaired platelet functions associated with NSAIDs may cause more severe upper GI bleeding. Clinicians should be alert for GI complications especially in older patients and in those with a history of ulcer bleeding.
authors.affiliation: Department of Hematology, Medicine Faculty, Dicle University, Diyarbakir, Turkey. semirpasa@dicle.edu.tr
authors.forename: Semir
authors.initials: S
authors.lastname: Pasa
authors.forename: Kadim
authors.initials: K
authors.lastname: Bayan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucukoner
authors.forename: Yekta
authors.initials: Y
authors.lastname: Tuzun
authors.forename: Abdullah
authors.initials: A
authors.lastname: Altintas
authors.forename: Timucin
authors.initials: T
authors.lastname: Cil
authors.forename: Ramazan
authors.initials: R
authors.lastname: Danis
authors.forename: Orhan
authors.initials: O
authors.lastname: Ayyildiz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001792:Blood Platelets / Q000378:metabolism*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests; D012720:Severity of Illness Index
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal