Objective-To investigate the effect of rosuvastatin on platelet deposition under controlled shear rate conditions and to identify new platelet proteins involved in the interaction with the activating substrate. Methods and Results-Platelet-vessel wall interaction and thrombosis take place under dynamic conditions involving the interaction of the exposed damaged vascular wall with the circulating blood cells and proteins. Blood was perfused over type I collagen at different wall shear rates, and platelet deposition was measured by confocal microscopy. Perfused effluent blood was collected, platelets were sequentially extracted based on differential protein solubility, and proteins were separated by 2D gel electrophoresis. Blockade of 3-hydroxy-3-methylglutaryl-coenzyme A reductase significantly reduced platelet deposition and modulated the expression pattern of 18 proteins in the platelet subproteome. Among them, an increase in platelet surface 78-kDa glucose-regulated protein (GRP78), a stress-inducible multifunctional endoplasmic reticulum protein, was clearly apparent. Immunoprecipitation of platelet GRP78 revealed its interaction with tissue factor. Moreover, blockade of surface GRP78 resulted in a substantial increase in platelet deposition and tissue factor procoagulant activity and in a decrease in clotting time. Conclusion-These findings demonstrate that blockade of 3-hydroxy-3-methylglutaryl-coenzyme A reductase reduces platelet deposition and inhibits GRP78 translocation from the platelet surface after shear and collagen activation. For the first time to our knowledge, this study reports on the presence and functional role of GRP78 in platelets and indicates that GRP78 has additional functions beyond those of a molecular chaperone. Key Words: platelets Ⅲ thrombosis Ⅲ glucose-regulated protein 78 Ⅲ statins Ⅲ thrombosis Ⅲ tissue factor T he first response to vascular injury consists of platelet adhesion to the damaged vessel wall or to exposed tissue components and is mediated by flow-regulated interactions that have a key influence on subsequent thrombus growth, often culminating in life-threatening complications. 1 Clinical results strongly suggest that the beneficial effects of statins (3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors) may also be related to factors beyond lowering systemic lipid levels. 2,3 The effects of statins are mediated via blockade of mevalonate formation, which results in reduction of cholesterol synthesis. The inhibition of mevalonate formation also results in reduced levels of isoprenoid derivatives, which play important roles in the isoprenylation of small GTPases of the Rho/Rac/Cdc42 family. 4 -6 Isoprenylation facilitates activation and translocation of these proteins from the cytosol to the plasma membrane and thereby supports the function of these intracellular signaling pathways, which are necessary for many cellular processes in the cardiovascular system. 4,7,8 Indeed, statins inhibit cell proliferation, improve endothelial function, reduce in...