Increased Platelet Reactivity and Circulating Monocyte-Platelet Aggregates in Patients With Stable Coronary Artery Disease

Objectives. We sought to examine whether patients with stable coronary artery disease (CAD) have increased platelet reactivity and an enhanced propensity to form monocyte-platelet aggregates. Background. Platelet-dependent thrombosis and leukocyte infiltration into the vessel wall are characteristic...

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Published in:	Journal of the American College of Cardiology Vol. 31; no. 2; pp. 352 - 358
Main Authors:	Furman, Mark I, Benoit, Stephen E, Barnard, Marc R, Valeri, C.Robert, Borbone, Marie L, Becker, Richard C, Hechtman, Herbert B, Michelson, Alan D
Format:	Journal Article
Language:	English
Published:	New York, NY Elsevier Inc 01-02-1998 Elsevier Science
Subjects:	Adenosine Diphosphate - pharmacology Adult Angina Pectoris - blood Angina Pectoris - pathology Biological and medical sciences Cardiology. Vascular system Cell Adhesion Cell Adhesion Molecules - pharmacology Cell Count Cell Degranulation Cell Movement Coronary Artery Disease - pathology Coronary Disease - blood Coronary Disease - pathology Coronary heart disease Coronary Vessels - pathology Epinephrine - pharmacology Female Flow Cytometry Heart Humans Leukocytes - physiology Male Medical sciences Middle Aged Monocytes - physiology P-Selectin - analysis Peptide Fragments - pharmacology Platelet Activation - drug effects Platelet Activation - physiology Platelet Aggregation - drug effects Platelet Aggregation - physiology Receptors, Thrombin - agonists Thrombosis - blood FITC RANTES CAD GP TRAP ADP Ig Human Platelet Reactivity Monocyte Cardiovascular disease Exploration Aggregate Angina pectoris Coronary heart disease
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Summary:	Objectives. We sought to examine whether patients with stable coronary artery disease (CAD) have increased platelet reactivity and an enhanced propensity to form monocyte-platelet aggregates. Background. Platelet-dependent thrombosis and leukocyte infiltration into the vessel wall are characteristic cellular events seen in atherosclerosis. Methods. Anticoagulated peripheral venous blood from 19 patients with stable CAD and 19 normal control subjects was incubated with or without various platelet agonists and analyzed by whole blood flow cytometry. Results. Circulating degranulated platelets were increased in patients with CAD compared with control subjects (mean [±SEM] percent P-selectin–positive platelets: 2.1 ± 0.2 vs. 1.5 ± 0.2, p < 0.01) and were more reactive to stimulation with 1 μmol/liter of adenosine diphosphate (ADP) (28.7 ± 3.9 vs. 16.1 ± 2.2, p < 0.01), 1 μmol/liter of ADP/epinephrine (51.4 ± 4.6 vs. 37.5 ± 3.8, p < 0.05) or 5 μmol/liter of thrombin receptor agonist peptide (TRAP) (65.7 ± 6.8 vs. 20.2 ± 5.1, p < 0.01). Patients with stable CAD also had increased circulating monocyte-platelet aggregates compared with control subjects (percent platelet-positive monocytes: 15.3 ± 3.0 vs. 6.3 ± 0.9, p < 0.01). Furthermore, patients with stable CAD formed more monocyte-platelet aggregates than did control subjects when their whole blood was stimulated with 1 μmol/liter of ADP (50.4 ± 4.5 vs. 28.1 ± 5.3, p < 0.01), 1 μmol/liter of ADP/epinephrine (60.7 ± 4.3 vs. 48.0 ± 4.8, p < 0.05) or 5 μmol/liter of TRAP (67.6 ± 5.7 vs. 34.3 ± 7.0, p < 0.01). Conclusions. Patients with stable CAD have circulating activated platelets, circulating monocyte-platelet aggregates, increased platelet reactivity and an increased propensity to form monocyte-platelet aggregates.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0735-1097 1558-3597
DOI:	10.1016/S0735-1097(97)00510-X