Thromb Haemost 1976; 35(03): 702-711
DOI: 10.1055/s-0038-1647968
Original Article
Schattauer GmbH

Spontaneous Platelet Aggregation in Arterial Insufficiency: Mechanisms and Implications

Kenneth K. Wu
1   From Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois and University of Iowa Hospitals, Iowa City, Iowa USA
,
John C. Hoak
1   From Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois and University of Iowa Hospitals, Iowa City, Iowa USA
› Author Affiliations
Further Information

Publication History

Received 27 October 1975

Accepted 03 January 1976

Publication Date:
02 July 2018 (online)

Summary

To investigate the clinical implications and mechanisms of spontaneous platelet aggregation (SPA) in man, 150 normal subjects, 22 patient controls and 130 patients with vascular insufficiency were studied. SPA was negative in normal subjects and patient controls whereas it was positive in 36 of 66 (54%) patients with transient ischemic attacks, 6 of 32 (19%) patients with stable angina, 7 of 10 (70%) patients with acute myocardial infarction and 11 of 14 (80%) patients with acute peripheral arterial insufficiency. The SPA was inhibited with aspirin in vivo, and inhibited competitively in vitro by low concentrations of aspirin, 2-chloroadenosine, prostaglandin E1 or apyrase but only by high concentrations of heparin or hirudin. Addition of platelet-poor plasma from patients with positive SPA did not cause normal platelets to aggregate. Treatment of patients who had acute peripheral arterial insufficiency with aspirin and dipyridamole prevented SPA with notable clinical improvement of the ischemic changes.

 
  • References

  • 1 Ardlie N. G, Perry D. W, Packham M. A, Mustard J. F. 1972; Influence of apyrase in stability of suspensions of washed rabbit platelets. Proceedings of the Society for Experimental Biology and Medicine 136: 1021.
  • 2 Born G. V. R. 1962; Aggregation of blood platelets by adenosine diphosphate and its reversal. Nature 194: 927.
  • 3 Born G. V. R. 1964; Strong inhibition of 2-chloroadenosine on the aggregation of blood platelets by adenosine diphosphate. Nature 202: 95.
  • 4 Born G. V. R, Cross M. J. 1964; Effects of inorganic ions and of plasma proteins on the aggregation of blood platelets by adenosine diphosphate. Journal of Physiology 170: 397.
  • 5 Danta G. 1970; Second phase platelet aggregation induced by adenosine diphosphate in patients with cerebral vascular disease and in control subjects. Thrombosis et Diathesis Haemorrhagica 23: 159.
  • 6 Dreyfuss F, Zahavi J. 1973; Adenosine diphosphate induced platelet aggregation in myocardial infarction and ischemic heart disease. Atherosclerosis 17: 107.
  • 7 Friedlander L, Cook I. J. Y, Hawkey C, Symons C. 1971; A laboratory study of spontaneous platelet aggregation. Journal of Clinical Pathology 24: 323.
  • 8 Greenberg J, Packham M. A, Cazenave J, Reimers H. J, Mustard J. F. 1975; Effects on platelet function of removal of platelet sialic acid by neuraminidase. Laboratory Investigation 32: 476.
  • 9 Hampton J. R, Gorlin R. 1972; Platelet studies in patients with coronary artery disease and in their relatives. British Heart Journal 34: 465.
  • 10 Harker L. A, Slighter S. J. 1974; Arterial and venous thromboembolism: kinetic characterization and evaluation of therapy. Thrombosis et Diathesis Haemorrhagica 31: 188.
  • 11 Hill A. G. 1961. Principles of Medical Statistics.. The Lancet Limited; London:
  • 12 Hoak J. C. 1972; Freeze-etching studies of human platelets. Blood 40: 514.
  • 13 Kardinal C. G, Wagner L. T, Anderson L. K. 1975; Spontaneous platelet aggregation: occurrence in an asymptomatic individual. American Journal of Clinical Pathology 63: 559.
  • 14 Kinlough-Rathbone L, Packham M. A, Mustard J. F. 1970; The effect of prostaglandin E1 on platelet function in vitro and in vivo . British Journal of Haematology 19: 559.
  • 15 Mustard J. F. 1970; Platelets in thromboembolic disease. Advances in Cardiology 4: 131.
  • 16 Mustard J. F, Perry D. W, Ardlie N. G, Packham M. A. 1972; Preparation of suspensions of washed platelets from humans. British Journal of Haematology 22: 193.
  • 17 O’Brien J. R, Heywood J. B, Heady J. A. 1966; The quantitation of platelet aggregation induced by four compounds: a study in relation to myocardial infarction. Thrombosis et Diathesis Haemorrhagica 16: 752.
  • 18 Preston F. E, Emmanuel I. G, Winfield D. A, Malia R. G. 1974; Essential thrombocythaemia and peripheral gangrene. British Medical Journal 3: 548.
  • 19 Salky N, Dugdale M. 1973; Platelet abnormalities in ischemic heart disease. American Journal of Cardiology 32: 612.
  • 20 Tocantins L. M. 1964. Removal and application of silicone. In: Tocantins L. M, Kazal L. A. (eds.) Blood Coagulation, Hemorrhage and Thrombosis.. Grune and Stratton; New York: 9.
  • 21 Vreeken J, Van Aken W. G. 1971; Spontaneous aggregation of blood platelets as a cause of idiopathic thrombosis and recurrent painful toes and fingers. Lancet 2: 1394.
  • 22 Weiss H. J, Aldort L. M, Kochwa S. 1968; The effect of salicylates on the hemostatic properties of platelets in man. Journal of Clinical Investigation 47: 2169.