November 23, 1970

Aspirin and Bleeding Time

JAMA. 1970;214(8):1565. doi:10.1001/jama.1970.03180080145036

To the Editor.—  It is encouraging to note that my observation1 of 1966 that aspirin increased the bleeding time and my efforts to alert the medical profession to its potential danger, especially in bleeders,2 are slowly gaining recognition and support. Particularly interesting is the report (213:2049, 1970) on "Studies on the Detection of Adverse Drug Reactions in the Newborn: I. The Effects of Prenatal Aspirin on Newborn Hemostasis." Unfortunately, the adverse effects observed clinically are explained by a unilateral approach based on the uncritical concept that defective hemostasis is primarily brought about by either a platelet or a coagulation defect, and then neglecting to study either adequately. The prothrombin consumption time test was not employed and, yet, without this test, neither coagulation nor platelet dysfunction can be accurately evaluated. The bleeding time, which is one of the few reliable procedures for studying the vascular response in hemostasis