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Duration of increased bleeding tendency after cessation of aspirin therapy

Ronan A Cahill1, Gerard T McGreal, Basil H Crowe

  • 1Department of Surgery, NUI (Cork), Cork University Hospital, Cork, Ireland.

Journal of the American College of Surgeons
|April 5, 2005
PubMed

Insights

Withholding aspirin for 5 days before surgery is recommended. This allows bleeding times and platelet function to normalize, reducing surgical bleeding risks without increasing thrombosis risk.

Area of Science:

  • Pharmacology
  • Hematology
  • Surgical Medicine

Background:

  • Aspirin significantly impacts hemostasis, necessitating its discontinuation before elective surgery.
  • Withholding aspirin poses a thrombosis risk, making the optimal cessation period critical.
  • The precise duration for aspirin withdrawal remains a subject of debate.

Purpose of the Study:

  • To determine the duration of aspirin's antihemostatic effect after prolonged therapy.
  • To provide evidence-based guidance on aspirin cessation before surgery.

Main Methods:

  • Prospective study involving 51 healthy volunteers.
  • Randomized assignment to placebo, 75 mg aspirin, or 300 mg aspirin daily for 14 days.
  • Assessment of template bleeding times and platelet function (PFA-100) until baseline normalization.

Main Results:

  • Bleeding times normalized within 96 hours; platelet function tests normalized within 144 hours post-aspirin cessation.
  • No persistent hemostatic defects were observed beyond the sixth day after stopping aspirin.
  • Both 75 mg and 300 mg aspirin doses showed similar durations of effect.

Conclusions:

  • Sensitive platelet function measures confirm the duration of increased bleeding tendency after aspirin withdrawal.
  • Discontinuing aspirin 5 days prior to elective surgery is supported.
  • Surgery on the sixth day after cessation is deemed safe regarding aspirin's hemostatic effects.
Abstract

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