Platelet Consumption in Cardiovascular Disease

Abstract

Many tests have been devised to investigate the role of platelets in arterial or venous thromboembolism. The mechanisms of platelet reactivity that the tests have measured have been variable and the early studies have been of little value in determining the contribution of platelet consumption in thromboembolic diseases. More recently, tests of in vivo platelet release and of platelet survival and turnover have been introduced and thought to be of great potential in the investigation of thromboembolic disorders. However, the data published thus far using more tests are far from conclusive that platelet activation and consumption occurs in thromboembolic disorders associated with arteriosclerosis. It may be that they are neither sensitive nor specific enough to detect minor changes in platelet activation. There is, however, some consistency that in conditions involving the larger vessels, prosthetic surfaces, or in association with active and recurrent venous thromboembolism, platelet release and platelet consumption measured by platelet survival time may occur. In particular, the abnormal results are consistently found in acute and recurrent venous thromboembolism, cardiac valve replacement with the older prosthetic devices, and arteriosclerosis of the larger arteries with clinical episodes of thromboembolism. However, in coronary artery disease, cerebrovascular disease, and peripheral vascular disease, the data are inconclusive, probably because the tests lack sensitivity. In addition, the value of the tests in the management of patients with thromboembolic disorders appears to be limited.

Platelet Function in Patients with Chronic Coronary Heart Disease on Long-Term Anticoagulant Therapy: Effect of Anticoagulant Stopping

“…This is in agreement with the results of the present study, since in our CHD patients without ACT and several years after their myocardial infarctions high levels of pTG were found. Nevertheless, and in accordance with other authors [19], in a certain percent age of these patients (41%) pTG levels over lapped with the values of the normal popula tion. In patients on ACT with an adequate level of hypocoagulability we have also found high levels of circulating PTG, which is in accordance with the results of Miihlhauser et al [22] in coronary artery disease patients.…”

“…Although it appears to be widely accepted that platelets play a role in the pathogenesis of CHD, the data in the literature regarding platelet function in these patients is contro versial [19]. However, high levels of plasma PTG have been reported in CHD patients [20,21].…”

Therapeutic Potentials of Sarpogrelate in Cardiovascular Disease*

“…Antithrombotic effect in patients with peripheral vascular disease. High levels of plasma 5-HT have been clinically observed in patients with peripheral vascular disease (PVD), which is associated with thrombus formation (7,153). The collateral vessels developed in these patients are sensitive to the vasoconstrictor effect of 5-HT (102,123).…”

Pathophysiology of myocardial ischemia: Importance of platelet-vessel wall interactions

“…This whole area has been well summarized [4]. The reason is their major, often primary, role in the thrombotic process in coronary arteries.…”