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Thromb Haemost 2001; 85(06): 989-994
DOI: 10.1055/s-0037-1615952
Review Article
Schattauer GmbH

Platelet Reactivity in Acute Coronary Syndromes: Evidence for Differences in Platelet Behaviour between Unstable Angina and Myocardial Infarction

Anthony Mathur
,
Monique S. C. Robinson
1   Haemostasis Research Unit, Department of Haematology, University College London, London, UK
,
James Cotton
,
John F. Martin
,
Jorge D. Erusalimsky
› Author Affiliations
Further Information

Publication History

Received 10 August 2000

Accepted after resubmission 31 January 2001

Publication Date:
12 December 2017 (online)

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Summary

Previous work has shown that P-selectin and mean platelet volume, two markers associated with platelet reactivity, are elevated in acute coronary syndromes. This study investigated the possibility that these markers may define unstable angina (UA) and acute myocardial infarction (MI) as two separate conditions based on platelet behaviour. Mean platelet volume (MPV) was higher in UA patients (n = 15) than in those diagnosed with MI (n = 15) (10.7 ± 0.25 fL, vs. 9.8 ± 0.27 fL, P = 0.005). Platelet count was lower in UA than in MI (215 ± 13 × 109/L vs. 271 ± 20 × 109/L, P = 0.03). The percentage of platelets expressing P-selectin was higher in MI than in UA (9.1 ± 1.9% vs. 4.2 ± 0.85%, P = 0.03). This parameter was positively correlated with MPV in UA (r = 0.5, P = 0.04) but negatively correlated in MI (r = -0.6, P = 0.01), with no correlation for ACS as a whole (r = –0.32, P = 0.1). Our results suggest that in MI there is an acute process of generalised platelet activation that is unrelated to changes in MPV, whereas in UA there is an ongoing process of platelet consumption that leads to an increase in platelet size to compensate for a persistent decrease in platelet count. This study suggests that there is a fundamental difference in platelet biology between these two diseases.

Key words

Platelets - P-selectin - mean platelet volume - unstable angina - myocardial infarction
 

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