Effects of medications, supplements, and pre-procedural factors on platelet function and the quality of autologous platelet concentrates: A critical literature review

Autologous platelet concentrates are biological products whose composition and functional properties depend not only on preparation protocols but also on donor-related and pre-procedural variables that may influence platelet number, reactivity, aggregation, activation, and mediator release. This critical literature review analyzed evidence concerning the effects of medications, dietary supplements, and non-pharmacological pre-procedural factors on platelet function and on the quantitative, functional, and biochemical characteristics of autologous platelet concentrates. The evidence encompassed antiplatelet agents, nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, direct oral anticoagulants, corticosteroids, statins, dietary supplements, physical exercise, smoking, alcohol exposure, postprandial conditions, and donor-related physiological variables. Pharmacological effects were agent-, pathway-, and endpoint-specific, and evidence obtained directly from platelet-rich plasma or related autologous preparations was distinguished from findings derived from systemic or experimental platelet-function studies. Aspirin, clopidogrel, and selected nonsteroidal anti-inflammatory drugs were associated with functional or biochemical alterations under defined experimental conditions, including changes occurring without concomitant modification of platelet concentration. Temporal evidence showed that recovery patterns depended on the specific drug and biological endpoint assessed and did not support a universal pre-procedural discontinuation interval. Evidence concerning dietary supplements was heterogeneous and predominantly based on systemic platelet-function or hemostatic outcomes, limiting direct extrapolation to platelet-rich plasma. Physical exercise produced protocol-dependent quantitative or biochemical changes directly measurable in platelet-rich plasma, whereas age and baseline platelet count contributed to variability among preparations. Overall, the evidence demonstrates that platelet quantity, platelet function, and the biochemical characteristics of autologous concentrates represent related but non-equivalent dimensions. Distinguishing effects demonstrated directly in autologous platelet concentrates from systemic or experimental platelet findings, as well as experimentally evaluated recovery periods from pharmacological inference, provides a more rigorous framework for characterizing pre-procedural variables and interpreting the biological variability and reproducibility of autologous platelet products.