SUMMARY A significant increase in platelet adhesiveness was observed in 13 patients who developed ischaemic stroke at high altitude and in 43 patients who developed stroke at low altitude when compared with a similar group of normal healthy volunteers. Eighty-eight percent of the patients were below the age of 40 years. The role of platelet adhesiveness in the pathogenesis of cerebral schaemia in young patients is discussed.

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Fibrinolytic activity and platelet adhesiveness are normal in cases of angina pectoris and healed myocardial infarction, whereas fibrinolytic activity is diminished in acute myocardial infarction. Exercise increases fibrinolytic activity in normal people but the effect on it of submaximal exercise in patients with ischaemic heart disease is not known. Resting platelet adhesiveness and fibrinolytic activity were determined in 20 patients suffering from ischaemic heart disease and eight healthy controls. Both groups were then subjected to submaximal exercise on a motor-driven treadmill. The ST segment of the electrocardiogram and the heart rate were monitored during exercise by an on-line digital computer. Fibrinolytic activity determinations were repeated immediately after exercise. There was a significant increase in fibrinolytic response in both groups but it was significantly less in the ischaemic groups (36.2%) compared with the controls (55.9%) (P < 0.01).The ST segment depression was 2-3 mm in the ischaemic group and 0-52 mm in controls-also a significant difference (P <0O01). There was no correlation, however, between the ST change and thefibrinolytic response. A diminished response in the ischaemic group may favour their predisposition to thrombotic episodes.

SUMMARY In a search for a possible 'hypercoagulable' state in myocardial infarction, platelet adhesiveness, plasma fibrinogen, and euglobulin lysis time were estimated in 48 cases of acute myocardial infarction and in 15 age-matched normals. An increase in platelet adhesiveness (P <0 05), plasma fibrinogen (P < 001), and fibrinolytic activity (P < 0.001) was noted in the patients when compared with normals.