Title Vitamin E in Combination With Aspirin Can Pose Potential Postoperative Bleeding
Clinical Question In a patient undergoing oral surgery, can vitamin E in combination with aspirin pose increased risk of postoperative bleeding?
Clinical Bottom Line Both articles indicate the enhanced anti-platelet effect of aspirin in combination with vitamin E.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
11940487Celestini/2002Healthy Human (blood) taking no medication.In vitro study
Key resultsThe anti-platelet aggregation effect of acetylsalicylic acid was enhanced in presence of vitamin E, by increasing the NO(nitrous oxide) production 42 fold(P < 0.05).
16011961Gonzalez-Correa/2005Whole blood from healthy male who had not taken any medication at least 15 days prior.In vitro Study
Key resultsVitamin E(50 and 100 µM) inhibited the aggregation of platelets in aspirin(2-20 µg/mL) treated platelets. The presence of Vitamin E in combination with aspirin required a higher collagen concentration to receive 50% maximal platelet activation. “(7.77±0.38 µg/mL and 10.82±0.46 µg/mL, respectively versus 4.25±1.03 µg/mL of untreated aspirinated-platelets; p< 0.0001)”
Evidence Search (("Aspirin"[Mesh]) AND "Vitamin E"[Mesh]) AND "Blood Platelets"[Mesh]
Comments on
The Evidence
The strength of evidence found in these articles were not significantly valid. None had an obvious competing interest in their trial. None of the articles conducted meta-analysis.
Applicability It is imperative for Clinician's to be aware and take in to account the possible adverse effect of patients that are taking Vitamin E in combination with aspirin.
Specialty (Oral Medicine/Pathology/Radiology) (Endodontics) (General Dentistry) (Oral Surgery) (Periodontics) (Dental Hygiene)
Keywords Vitamin E, Acetylsalicylic acid, collagen, antiplatelet aggregation
ID# 2440
Date of submission 04/01/2013
E-mail Heydaris3@livemail.uthscsa.edu
Author Soulmaz Heydari
Co-author(s) e-mail
Faculty mentor Gregory Spackman, DDS, MBA
Faculty mentor e-mail spackman@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available