Effects of chronic administration of valproic acid to epileptic patients on coagulation tests and primary hemostasis

Epilepsia
Maddalena L ZighettiMarco Cattaneo

Abstract

Valproic acid (VPA) is an antiepileptic drug that has been associated with impaired hemostasis and increased risk for postsurgical bleeding. However, the published reports provide controversial results. We measured parameters of primary hemostasis in VPA-treated patients with epilepsy, focusing on adenosine nucleotide-dependent platelet responses, which play a central role in primary hemostasis. We enrolled 20 cases (epileptic patients receiving treatment with VPA) and 20 controls (12 epileptic patients receiving treatment with drugs different from VPA and 8 healthy subjects). Measurements included prothrombin time (PT), activated partial thromboplastin time (APTT), platelet count, platelet function analyzer (PFA)-100 closure times, plasma von Willebrand factor levels, platelet content of ADP, ATP, and serotonin (all stored in platelet dense granules), and platelet shape change and aggregation induced by ADP and other platelet agonists, including the ATP analog α,β-methylene-ATP. The plasma concentration of VPA was in the therapeutic range in 17 patients and slightly above the upper limit in 3 patients. There were no statistically significant differences in any of the studied parameters in cases versus controls. Our thorough co...Continue Reading

References

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Citations

Jun 29, 2016·Epilepsia·Adys MendizabalAllison W Willis
Jun 23, 2019·Journal of Pediatric Rehabilitation Medicine·Mohan BelthurM Wade Shrader
May 2, 2017·European Journal of Anaesthesiology·Sibylle A Kozek-LangeneckerKai Zacharowski
Jun 1, 2017·European Stroke Journal·Martin HoltkampUNKNOWN European Stroke Organisation
Jun 9, 2020·Seizure : the Journal of the British Epilepsy Association·Anastasia DresslerChristoph Male

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