The effects of corticosteroids and nonsteroidal anti-inflammatory drugs, including aspirin, on coagulation

Abstract

The immune and coagulation systems have numerous interactions, as evidenced by the increased risk of venous thromboembolism in inflammatory bowel disease. In general, proinflammatory states are prothrombotic, while a reduction in inflammation reduces thrombotic risk. Corticosteroids, such as hydrocortisone and prednisone, tend to reduce inflammation and thus thrombosis, while being prothrombotic in non-inflammatory states, e.g. Cushing’s syndrome. The nonsteroidal anti-inflammatory drugs also have a dual effect, through interaction with different cyclo-oxygenase enzyme isoforms, on platelets and the vascular endothelium.