Thromb Haemost 1987; 58(02): 714-717
DOI: 10.1055/s-0038-1645979
Original Articles
Schattauer GmbH Stuttgart

The Platelet Volume Distribution: A Signature of the Prethrombotic State in Coronary Heart Disease?

E A Trowbridge
The University Departments of Medical Physics and Clinical Engineering and Medicine, The Royal Hallamshire Hospital, Sheffield, UK
,
J F Martin
The University Departments of Medical Physics and Clinical Engineering and Medicine, The Royal Hallamshire Hospital, Sheffield, UK
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Publikationsverlauf

Received 22. Januar 1987

Accepted after revision 24. März 1987

Publikationsdatum:
27. Juni 2018 (online)

Summary

A coronary care unit population of 175 consecutive patients was studied. A clinical diagnosis of acute myocardial infarction was made in 103 cases (MI group) while 72 had chest pain, ECG indications of myocardial ischaemia, but no other clinical signs of acute myocardial infarction (control group). Based on bivariate Gaussian statistics the MI group could be divided in two groups, with respect to the platelet parameters of count and volume. The majority (65%) had large mean platelet volume and low count, while the remainder were indistinguishable from the control group. Patients with a large mean platelet volume also had significantly different volume distributions when assessed for volume dispersion, asymmetry and convexity. It is argued that this platelet volume distribution provides a signature for the prethrombotic state in ischaemic heart disease. Identification of such a platelet signature in a patient with coronary artery disease may allow appropriate prophylactic action to be taken and reduce the risk of subsequent acute myocardial infarction.

 
  • References

  • 1 Haft J I. Role of blood platelets in coronary artery disease. Amer J Cardiol 1979; 43: 1197-206
  • 2 Harker L A, Ritchie J L. The role of platelets in acute vascular events. Circulation 1980; 62 supp (15) V 13-8
  • 3 Sinzinger H. Role of platelets in atherosclerosis. Sem Thromb Hemost 1986; 12: 124-33
  • 4 O’Brien J R, Etherington M, Jamieson S, Klaber M R, Lincoln S V. Stressed template bleeding-time and other platelet function tests in myocardial infarction. Lancet 1973; i 694-6
  • 5 Cameron H A, Phillips R, Ibbotson R M, Carson P HM. Platelet size in myocardial infarction. Br Med J 1983; 287: 449-51
  • 6 Martin J F, Plumb J, Kilbey R S, Kishk Y T. Changes in platelet volume and density in myocardial infarction. Br. Med. J. 1983; 287: 456-9
  • 7 Kishk Y T, Trowbridge E A, Martin J F. Platelet volume subpopulations in acute myocardial infarction: an investigation of their homogeneity for smoking, infarct size and site. Clin Sci 1985; 68: 419-25
  • 8 Trowbridge E A, Martin J F, Slater D N. et al The origin of platelet count and volume. Clin Phys Physiol Meas 1984; 5: 145-70
  • 9 Trowbridge E A, Warren C W, Martin J F. Platelet volume heterogeneity in acute thrombocytopenia. Clin Phys Physiol Meas 1986; 7: 203-10
  • 10 WHO Expert Committee on Cardiovascular Disease and Hypertension. Hypertension and Coronary Heart Disease: Classification and Criteria for Epidemiological Studies. World Health Organization Technical Report Series No 168. WHO; Geneva: 1959. pp 3-28
  • 11 Zoll P M, Wessler S, Blungart H L. Angina pectoris: a clinical and pathological correlation. Amer J Med 1951; 11: 331-57
  • 12 Allison R B, Rodriguez F L, Higgins Jr E A. et al Clinico pathologic correlations in coronary atherosclerosis: four hundred and thirty patients studied with post mortem coronary angiography. Circulation 1968; 27: 170-184
  • 13 Martin J F, Trowbridge E A, Salmon G L, Slater D N. The relationship between megakaryocyte and platelet volume. Thromb Res 1982; 28: 447-59
  • 14 Martin J F, Shaw T, Heggie J, Penington D G. Measurement of the density of human platelets and its relationship to volume. Br J Haematol 1983; 54: 337-52
  • 15 Sewell R, Ibbotson R M, Phillips R, Carson P. High mean platelet volume after myocardial infarction: is it due to consumption of small platelets?. Br Med J 1984; 289: 1576-8
  • 16 Thompson C, Eaton K A, Princiotta S M. et al Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50: 509-19
  • 17 Trowbridge E A, Slater D N, Kishk Y T. et al Platelet production in myocardial infarction and sudden cardiac death. Thromb Haemostas 1984; 52: 167-71
  • 18 Martin J F, Trowbridge E A, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B production and megakaryocyte nuclear DNA concentration. Thromb Res 1983; 32: 443-60
  • 19 Lewis H D, Davis J W, Archibald D G. et al Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of Veterans Administration cooperative study. N Eng J Med 1983; 309: 396-403
  • 20 Maseri A, Severi S, Marzullo P. Role of coronary arterial spasm in sudden coronary ischaemic death. Ann NY Acad Sci 1982; 382: 204-17
  • 21 Tindale W B, Trowbridge E A. Modification of the Gorlin equation for use with heart valve substitutes. Cardiovasc Res 1986; 20: 458-65
  • 22 Dawber T R, Kannel W B, Friedman G D. Vital capacity, physical activity and coronary heart disease. In Prevention of Ischemic Heart Disease: Principles and practice. Raab W. (ed) Springfield, Illinois: Charles C Thomas; 1966. pp 254-65
  • 23 Friedman G D, Klatsky A L, Siegelaub A B. Lung function and risk of myocardial infarction and sudden cardiac death. New England J Med 1976; 294: 1071-5