Effects of low-dose aspirin and fish oil on platelet function and NF-kappaB in adults with diabetes mellitus

Block, Robert C.; Abdolahi, Amir; Smith, Brian L.; Meednu, Nida; Thevenet-Morrison, Kelly; Cai, Xueya; Cui, Huadong; Mousa, Shaker A.; Brenna, J. Thomas; Georas, Steve N.

doi:10.1016/j.plefa.2013.03.005

Cited by 14 publications

(34 citation statements)

References 50 publications

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“…Baseline plasma concentrations averaged 106 ± 48 mg/ml for DHA and 13 ± 7 mg/ml for EPA, which increased to 190 ± 65 mg/ml (p<0.0001) for DHA and 61 ± 26 mg/ml for EPA (p<0.0001) 28 days after fish oil ingestion. 22 Figure 2 displays forest plots for the log transformed mean difference from baseline for HAE and HDL-C concentrations by blood draw. Each blood draw is representative of the exposure of interest for that blood draw (i.e., blood draw 3 is representative of the chronic effects, after 7 days of aspirin only).…”

Section: Resultsmentioning

confidence: 99%

“…However, observations reported here are consistent with our prior study in which the effects of aspirin on lysophosphatidic acids (highly atherogenic) and other platelet function agonist biomarkers using the same study population. 22 Given the relative concern of aspirin resistance in this population, these results offer a promising start for future public health interventions. Individuals with type 2 diabetes mellitus are particularly predisposed to “resist” the CVD beneficial effects of aspirin, including reduced incidence of death and acute coronary syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…21 Distribution of participant characteristics can be found in table 1, as previously described. 22 Individuals were excluded if they had a diagnosed CVD; recent history of malignancy, peptic ulcer, or bleeding disorder; use of antiplatelet or antithrombotic therapy, oral contraceptives, or NSAIDs; signs of any metabolic disease that would influence lipid metabolism; allergy to aspirin or fish oil; pregnancy; drug or alcohol abuse and tobacco use. Patients who enrolled were asked to refrain from flax seed oil, supplements and other fish oil containing products not including the study capsules.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…22,24 Briefly, all data were acquired and processed with Analyst 1.4.2 software (Applied Biosystem MSD Sciex, Carlsbad, California). The limit of detection was 45 pg for EPA, and 75pg for DHA.…”

Section: Participants and Methodsmentioning

confidence: 99%

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Effects of aspirin in combination with EPA and DHA on HDL-C cholesterol and ApoA1 exchange in individuals with type 2 diabetes mellitus

Block

Holub

Abdolahi

et al. 2017

Prostaglandins, Leukotrienes and Essential Fatty Acids

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Background/Synopsis Low-dose aspirin is an effective drug for the prevention of cardiovascular disease (CVD) events but individuals with diabetes mellitus can be subject to ‘aspirin resistance’. Thus, aspirin’s effect in these individuals is controversial. Higher blood levels of seafood-derived omega-3 polyunsaturated fatty acids (ω3) eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) also have beneficial effects in reducing risk of CVD events but few studies have examined the interaction of plasma EPA and DHA with aspirin ingestion. Objective/Purpose Our study examined the combinatory effects of EPA, DHA, and aspirin ingestion on HDL-cholesterol (HDL-C) and apoA-I exchange (shown to be associated with CVD event risk). Methods 30 adults with Type 2 diabetes mellitus ingested aspirin (81 mg/day) for 7 consecutive days, EPA+DHA (2.6g/day) for 28 days, then both for 7 days. Plasma was collected at baseline and at 5 subsequent visits including 4 hours after each aspirin ingestion. Mixed model methods were used to determine HDL-C-concentrations and apoA-I exchange compared to the baseline visit values. LOWESS curves were used for non-linear analyses of outcomes to help discern change patterns, which was followed by piecewise linear functions for formal testing of curvilinear relationships. Results Significant changes (p<0.05) compared to baseline in both HDL-C-concentrations and apoA-I exchange were present at different times. After 7 days of aspirin-only ingestion, apoA-I exchange was significantly modified by increasing levels of DHA concentration, with increased apoA-I exchange observed up until log(DHA) of 4.6 and decreased exchange thereafter (p=0.03). These LOWESS curve effects were not observed for EPA or HDL-C (p>0.05). Aspirin’s effects on apoA-I exchange were the greatest when EPA or DHA concentrations were moderate compared to high or low. Comparison of EPA, DHA, and EPA+DHA LOWESS curves, demonstrated that the majority of the effect is due to DHA. Conclusion Our results strongly suggest that plasma concentrations of EPA and DHA influence aspirin effects on lipid mediators of CVD event risk where their concentrations are most beneficial when moderate, not high or low. These effects on HDL-C cholesterol and apoA-I exchange are novel. Personalized dosing of DHA in those who take aspirin may be a beneficial option for patients with type 2 diabetes mellitus.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Participants and Methodsmentioning

confidence: 99%

Section: Participants and Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Effects of aspirin in combination with EPA and DHA on HDL-C cholesterol and ApoA1 exchange in individuals with type 2 diabetes mellitus

Block

Holub

Abdolahi

et al. 2017

Prostaglandins, Leukotrienes and Essential Fatty Acids

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show abstract

“…Longchain polyunsaturated fatty acids of fish oil can also function by competitive inhibition with arachidonic acid for the cyclooxygenase enzyme (25). These thromboprophylactic effects have also been found to be enhanced when fish oil is combined with aspirin (26)(27)(28). Therefore, fish oil can be a natural alternative medication, and play a marked role in VTE management in post-surgical patients.…”

Section: Introductionmentioning

confidence: 99%

Novel venous thromboembolic disease (VTED) prophylaxis for total knee arthroplasty—aspirin and fish oil

Bonutti¹,

Sodhi²,

Patel³

et al. 2017

Ann. Transl. Med.

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Background: Despite the demonstrated success of multiple anticoagulation therapies for post-operative prophylaxis of thromboembolic disease in lower extremity arthroplasties, each modality comes with a unique set of limitations. Thus, the ideal anticoagulation medication which provides adequate therapy with minimal cost, complications, or added patient work is yet to be defined. One promising novel thrombophylactic supplement is fish oil, as many preliminary clinical trials have demonstrated a protective effect of fish oil against thrombosis in multiple clinical settings. In addition, others have demonstrated synergistic effect when combined with aspirin. However, there are paucity of studies that compared combined aspirin and fish oil therapy for venous thromboembolism prophylaxis with other pharmacological agents, especially in the field of orthopaedics. Therefore, this study evaluated: (I) risk of post-operative deep vein thrombosis (DVT) and pulmonary embolism (PE), and (II) bleeding complications; among patients who had primary total knee arthroplasty (TKA) and received one of the following regimens: (i) 325 mg aspirin and mechanical pulsatile stocking; (ii) rivaroxaban; or (iii) 325 mg aspirin and 1,000 mg fish oil. and 95% confidence intervals (CIs), for thromboembolic and bleeding events were calculated and compared between the aspirin and fish oil cohort vs. aspirin and pulsatile stocking cohort, and aspirin and fish oil cohort vs. rivaroxaban cohort. A P value of <0.05 was used to determine statistical significance.Results: A total of 25 DVT events were recorded including 1 of 300 (0.33%) in the aspirin and fish oil cohort, 22 of 300 (7.33%) in the aspirin and pulsatile stocking cohort and 2 of 250 (0.8%) in the rivaroxaban cohort. When comparing ORs, patients who received aspirin and fish oil demonstrated significantly lower risk for thromboembolic events when compared to the aspirin and pulsatile stocking group (OR: 0.045; 95% CI: 0.0061-0.3394; P<0.05). When compared to the rivaroxaban cohort the ORs did not differ significantly (OR: 0.416; 95% CI: 0.0376-4.6223; P>0.05). In addition, no PE events were recorded in any of the cohorts.When compared to rivaroxaban, the fish oil and aspirin cohort demonstrated significantly lower incidence Bonutti et al. Aspirin and fish oil for TKA VTED

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Do elevated blood levels of omega-3 fatty acids modify effects of particulate air pollutants on fibrinogen?

Croft

Block

Cameron

et al. 2018

Air Qual Atmos Health

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Previously, we found short-term increases in ambient particulate matter (PM) air pollutant concentrations were associated with increased serum fibrinogen levels in patients with cardiac disease. We now studied whether high blood levels of omega-3 (ω-3) fatty acids blunted this fibrinogen response to increased PM concentrations in these same patients. Plasma fibrinogen and ω-3 fatty acid levels (% of total identified fatty acids) were measured in blood samples collected from 135 patients treated at the University of Rochester Medical Center for myocardial infarction or stable ischemic heart disease requiring cardiac catheterization. Using ambient measurements of ultrafine, accumulation mode, and fine particles (PM2.5), Delta-C, and black carbon (BC), we regressed serum fibrinogen levels against pollutant concentrations over the previous 1–96 h, using interaction terms to estimate these associations separately for those with HIGH (> 5.12%) and LOWMED serum levels of ω-3 fatty acid (≤ 5.12%). Each 5.6 μg/m3 increase in PM2.5 concentration in the previous hour was associated with a 3.1% increase in fibrinogen (95% CI = 1.5%, 4.7%) in those subjects with LOWMED total ω-3 fatty acid levels, but only a 0.9% increase (95% CI = − 1.5%, 3.2%) in patients with HIGH total ω-3 fatty acid levels. This same pattern was observed with fish oil-derived docosahexaenoic and eicosapentaenoic acids but not alpha-linolenic (from plant oil or seeds). A similar finding was observed with BC in the prior 24 h, but not other PM. Thus, increased blood levels of fish-based ω-3 fatty acids attenuated increases in fibrinogen associated with short-term increases in ambient PM.Electronic supplementary materialThe online version of this article (10.1007/s11869-018-0586-0) contains supplementary material, which is available to authorized users.

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Effects of low-dose aspirin and fish oil on platelet function and NF-kappaB in adults with diabetes mellitus

Cited by 14 publications

References 50 publications

Effects of aspirin in combination with EPA and DHA on HDL-C cholesterol and ApoA1 exchange in individuals with type 2 diabetes mellitus

Effects of aspirin in combination with EPA and DHA on HDL-C cholesterol and ApoA1 exchange in individuals with type 2 diabetes mellitus

Novel venous thromboembolic disease (VTED) prophylaxis for total knee arthroplasty—aspirin and fish oil

Do elevated blood levels of omega-3 fatty acids modify effects of particulate air pollutants on fibrinogen?

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