Indices of platelet activation and the stability of coronary artery disease
Department of Pediatrics; Department of Emergency Medicine; Department of Anesthesiology
Medical Subject Headings
Aged; Anti-Inflammatory Agents, Non-Steroidal; Aspirin; CD40 Ligand; Coronary Artery Disease; Epinephrine; Female; Humans; Male; Middle Aged; Neutrophils; P-Selectin; *Platelet Activation; Platelet Function Tests; Platelet Glycoprotein GPIIb-IIIa Complex
Hematology | Oncology | Pediatrics
AIM: To determine whether indices of platelet activation are associated with the stability of coronary artery disease (CAD).
METHODS: Platelet function was examined in 677 consecutive aspirin-treated patients presenting for cardiac catheterization. Patients were grouped into recent myocardial infarction (MI), no MI but angiographically documented CAD (non-MI CAD) and no angiographically detectible CAD (no CAD), as well as additional subgroups.
RESULTS: Compared with non-MI CAD or no CAD patients, more patients with recent MI had a shortened platelet function analyzer (PFA)-100 collagen-epinephrine closure time (CT) and increased circulating monocyte-platelet aggregates, neutrophil-platelet aggregates, activated platelet surface GPIIb-IIIa and plasma soluble CD40 ligand (sCD40L). More patients with non-MI CAD had shortened PFA-100 CTs and increased monocyte-platelet aggregates compared with patients with no CAD. Platelet surface P-selectin did not differ among the groups. Subgroup analysis revealed that decreasing PFA-100 CT correlated with the stability of CAD.
CONCLUSIONS: Indices of platelet activation, especially the PFA-100 CT, are associated with the stability of CAD, and may reflect plaque instability, an ongoing thrombotic state and/or reduced responsiveness to aspirin.
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Citation: J Thromb Haemost. 2007 Apr;5(4):761-5. Epub 2007 Feb 26. doi: 10.1111/j.1538-7836.2007.02462.x