In vivo prostacyclin biosynthesis and effects of different aspirin regimens in patients with essential thrombocythaemia

Viviana Cavalca, Bianca Rocca, Isabella Squellerio, Alfredo Dragani, Fabrizio Veglia, Francesca Pagliaccia, Benedetta Porro, Silvia Stella Barbieri, Elena Tremoli, Carlo Patrono

Research output: Contribution to journalArticlepeer-review


Essential thrombocythaemia (ET) is characterised by enhanced platelet generation and thrombosis. Once daily (od) aspirin incompletely inhibits platelet thromboxane (TX)A2 production in ET. A twice daily (bid) dosing is necessary to fully inhibit TXA2. Whether this dosing regimen affects in vivo prostacyclin (PGI2) biosynthesis is unknown. PGI2 biosynthesis was characterised in 50 ET patients on entericcoated (EC) aspirin 100 mg od, by measuring its urinary metabolite, 2,3-dinor-6-keto-PGF1α (PGI-M). Moreover, in a crossover study 22 patients poorly responsive to standard aspirin based on serum TXB2 levels (≥4 ng/ml) were randomised to different seven-day aspirin regimens: EC aspirin 100 mg od, 100 mg bid, 200 mg od, or plain aspirin 100 mg od. PGI-M measured 24 hours after the last aspirin intake (EC, 100 mg od) was similar in patients and healthy subjects both on (n=10) and off (n=30) aspirin. PGI-M was unrelated to in vivo TXA2 biosynthesis, and not affected by EC aspirin 100 mg bid or 200 mg od as compared to EC 100 mg od. PGI2 biosynthesis in aspirin-treated ET patients appears unrelated to TXA2 biosynthesis, and not affected by an improved aspirin regimen, demonstrating its vascular safety for future trials.

Original languageEnglish
Pages (from-to)118-127
Number of pages10
JournalThrombosis and Haemostasis
Issue number1
Publication statusPublished - 2014


  • Aspirin
  • Essential thrombocythaemia
  • Platelets
  • Prostacyclin
  • Thromboxane

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)


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