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Observational Study
. 2020 Jul 2;20(1):204.
doi: 10.1186/s12906-020-02990-9.

Synergistic platelet inhibition between Omega-3 and acetylsalicylic acid dose titration; an observational study

Harald Bagger  1 , Mattias Hansson  1 , Thomas Kander  1   2 , Ulf Schött  3   4
Affiliations
Observational Study

Synergistic platelet inhibition between Omega-3 and acetylsalicylic acid dose titration; an observational study

Harald Bagger et al. BMC Complement Med Ther. .

Abstract

Background: Omega-3 and acetylsalicylic acid (ASA) are two widely used "over-the-counter" drugs. Previous research has shown multiple electrode aggregometry (MEA) can detect ASA and varying Omega-3 platelet inhibiting effects. Synergistic platelet inhibiting effects of ASA and Omega-3 have been found using other methods than MEA. The aim of this study was to investigate the antiplatelet effects of Omega-3, and ASA synergism with MEA.

Methods: Ten healthy male volunteers ingested Omega-3 (1260 mg/day) for 5 days. MEA was used to analyse platelet function before and after Omega-3 intake. Aggregation was initiated using three different agonists and measured as area under the curve (AUC): adenosine diphosphate (ADP), thrombin receptor activating peptide (TRAP) and arachidonic acid (ASPI). Two concentrations of ASA were dose titrated ex vivo to 2 out of 3 ASPI test cells in order to measure synergism between Omega-3 and ASA.

Results: Following 5 days Omega-3 intake, ADP, TRAP and ASPI AUC did not change significantly. In vitro ASA before Omega-3 intake, reduced ASPI AUC < 30 U, indicating a strong platelet inhibiting effect. Below this AUC level, the 5 days Omega-3 intake increased ASPI-AUC with the ex vivo added low dose ASA (P = 0.02) and high dose ASA (P = 0.04).

Conclusions: No synergism between ASA and Omega-3 was found using the MEA ASPI test. The surprising increase in ASPI-AUC following Omega-3 intake and ex vivo ASA suggest that there are methodological issuses with the MEA ASPI test.

Trial registration: Trial registration ISRCTN78027929 . Registered 19 May 2015.

Keywords: Acetylsalicylic acid; Coagulation; Omega-3.

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Conflict of interest statement

All authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Results from multiple electrode aggregometry (MEA) before and after Omega-3 intake, using thrombocyte receptor activating peptide (TRAP) and adenosine diphosphate (ADP). Results are presented as mean with 95% confidence interval. N.S.: non-significant
Fig. 2
Fig. 2
Results from multiple electrode aggregometry (MEA) before and after Omega-3 intake using arachidonic acid (ASPI) without acetylsalicylic acid (ASA), with low dose ASA and with high dose ASA. Note the different scales on the y-axes. *p = <0.05
See this image and copyright information in PMC

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