Background: Triflusal irreversibly inhibits cycloxygenase-1, thus inhibiting platelet activation induced by Arachidonic Acid (AA). Meanwhile, the omega-3 fatty acids, EPA and DHA inhibit AA- and collagen-induced platelet activation, whereas they do not affect thrombin- and ADP-induced platelet aggregation.

Aims: We investigated the antiplatelet effect of Triflusal, EPA, DHA and their combination on platelet activation induced by various agonists.

Methods: Platelet Rich Plasma (PRP), isolated from blood of healthy volunteers was pre-incubated with Triflusal, EPA, DHA or their combination at various concentrations for 10min at 37ºC, prior to activation by AA, TRAP-6, and ADP (10µM, 0.3mM and 5µM, respectively). Platelet aggregation was determined by Light Transmittance Aggregometry.

Results: The minimum inhibitory effect of Triflusal, DHA or EPA towards AA-induced platelet aggregation (13.00±5.80%, 4.00±0.57% and 14.00±2.82%, respectively) was observed at final concentrations of 400µM, 150µM and 50µΜ, respectively. Importantly, Triflusal combined with DHA (400µM and 50µΜ, respectively), inhibited AA-induced platelet aggregation by 85.00±12.12% (n=4). The inhibitory effect of Triflusal+EPA was only 18.00±2.08% (n=3) whereas its combination with DHA and EPA inhibited AA-induced platelet aggregation by 92.00±6.92% (n=3). The minimum inhibitory effect of Triflusal, EPA or DHA towards TRAP-6-induced platelet aggregation (11.50±5.64%, 32.00±7.52% and 18.00±11.01%, respectively) was observed at final concentrations of 500µM, 50µM and 100µΜ, respectively. Importantly, Triflusal combined with EPA (500µM and 50µM, respectively) inhibited TRAP-6-induced platelet aggregation by 75.00±2.82%. Similar inhibitory potency exhibited the combination of Triflusal+EPA+DHA (71.00±10.40%), whereas the inhibitory effect of Triflusal+DHA was only 37.00±0.70%. ADP-induced platelet aggregation wasn’t significantly inhibited by Τriflusal, DHA, EPA or their combination.

Conclusions: DHA significantly improves Triflusal’s inhibitory effect towards AA-induced platelet aggregation, whereas in the presence of EPA, Triflusal expresses a potent inhibitory effect towards TRAP-6-induced platelet activation. The underlying mechanisms and the importance of these findings at the clinical level, in patients treated with Triflusal for the secondary prevention of ischemic events, need further investigation.

« Back to ISTH 2020 Congress

ISTH Congress Abstracts - https://abstracts.isth.org/abstract/omega-3-fatty-acids-significantly-improve-the-antiplatelet-profile-of-triflusal/