Download PDF
Thromb Haemost 1988; 59(03): 353-356
DOI: 10.1055/s-0038-1647494
Original Article
Schattauer GmbH Stuttgart

Bleeding Time and Platelet Volume in Acute Myocardial Infarction – A 2 Year Follow-Up Study

S Dalby Kristensen
The University Department of Medicine, Royal Hallamshire Hospital, Sheffield, UK
,
P C Milner
The University Department of Medicine, Royal Hallamshire Hospital, Sheffield, UK
,
J F Martin
The University Department of Medicine, Royal Hallamshire Hospital, Sheffield, UK
› Author Affiliations
Further Information

Publication History

Received 08 July 1987

Accepted after revision 04 January 1988

Publication Date:
29 June 2018 (online)

Also available at
  PDF Download Permissions and Reprints

Summary

The bleeding time is shortened and the mean platelet volume is increased in the acute phase of myocardial infarction. In this follow-up study we repeated the measurement of the bleeding time, the platelet count and the platelet volume distribution in 18 patients who had suffered from a definite acute myocardial infarction two years before and in 16 control patients who had been admitted with chest pain but no definite myocardial infarction at that time. At the time of follow-up the bleeding time was significantly lengthened in the myocardial infarction group (median values = 169 s and 209 s respectively), whereas it had shortened in the control group (median values = 258 s and 228 s respectively). Comparison of the platelet volume distribution curves of the myocardial infarction patients at time of infarction and 2 years later revealed a significantly higher percentage of small platelets and significantly lower percentages of both medium-sized and large platelets at the time of infarction. These changes in the platelet volume distribution could indicate consumption of medium-sized and large platelets at the time of myocardial infarction. None of the measured variables predicted which of the patients with acute myocardial infarction would subsequently re-infarct or die. In the patients studied with definite ischaemic heart disease (n = 26) a significant negative correlation between bleeding time and mean platelet volume was found. The shortened bleeding time in myocardial infarction is related to the acute event itself or preceeds it, but is reversed two years later.

Keywords

Acute myocardial infarction - Bleeding time - Platelets - Platelet volume
 

  • References

  • 1 Jørgensen KA, Dyerberg J. Platelets and atherosclerosis. Dan Med Bul 1980; 27: 253-259
    PubMedGoogle Scholar
  • 2 Packham MA, Mustard JF. The role of platelets in the development and complications of atherosclerosis. Seminars in Haematology 1986; 23: 08-26
    PubMedGoogle Scholar
  • 3 Eldor A, Avitzour M, Or R, Hanna R, Penchas S. Prediction of haemorrhagic diathesis in thrombocytopenia by mean platelet volume. Br Med J 1982; 285: 397-400
    CrossrefPubMedGoogle Scholar
  • 4 Thompson C, Eaton KA, Princiotta SM, Kushkin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50: 509-519
    CrossrefPubMedGoogle Scholar
  • 5 Martin JF, Plumb J, Kilbey RS, Kishk YT. Changes in volume and density of platelets in myocardial infarction. Br Med J 1983; 287: 456-459
    CrossrefPubMedGoogle Scholar
  • 6 Cameron HA, Philips R, Ibbotson RM, Carson PH M. Platelet size in myocardial infarction. Br Med J 1983; 287: 449-451
    CrossrefPubMedGoogle Scholar
  • 7 Sewell R, Ibbotson RM, Phillips R, Carson P. High mean platelet volume after myocardial infarction: is it due to consumption of small platelets?. Br Med J 1984; 289: 1576-1578
    CrossrefPubMedGoogle Scholar
  • 8 Harker L, Slichter S. The bleeding time as a screening test for evaluation of platelet function. N Engl J Med 1972; 287: 155-159
    CrossrefPubMedGoogle Scholar
  • 9 Milner PC, Martin JF. Shortened bleeding time in myocardial infarction and its relation to platelet mass. Br Med J 1985; 290: 1767-1770
    CrossrefPubMedGoogle Scholar
  • 10 World Health Organisation Working Party. Ischaemic heart disease registers. Part II. Copenhagen; WHO: 1969. (WHO Euro 5010[1] 1968.)
    Google Scholar
  • 11 Solman G, Brown R. Hospital registration in patients with acute myocardial infarction. Am Heart J 1970; 79: 761-768
    CrossrefPubMedGoogle Scholar
  • 12 Mielke CH. Measurement of the bleeding time. Thromb Haemostas 1984; 52: 210-211
    PubMedGoogle Scholar
  • 13 Martin JF, Shaw T, Heggie J, Penington DG. Measurement of the density of human platelets and its relationship to volume. Br J Haematol 1983; 54: 337-352
    CrossrefPubMedGoogle Scholar
  • 14 Jørgensen KA, Dyerberg J, Olesen AS, Stoffersen E. Acetylsalicylic acid, bleeding time and age. Thromb Res 1980; 19: 799-805
    CrossrefPubMedGoogle Scholar
  • 15 Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B2 production and megakaryocyte DNA concentration. Thromb Res 1983; 32: 443-460
    CrossrefPubMedGoogle Scholar
  • 16 Mueller HS, Ayres SM. Propranolol decreases sympathetic nervous activity during evolution of myocardial infarction in man. J Clin Invest 1980; 65: 338-346
    CrossrefPubMedGoogle Scholar
  • 17 Walinsky P, Smith JB, Lefer AM. et al Thromboxane A2 in acute myocardial infarction. Am Heart J 1984; 108: 868-872
    CrossrefPubMedGoogle Scholar
  • 18 Vesterqvist O, Edhag O, Green K, Henriksson P. In vivo production of thromboxane in acute human myocardial infarction: a preliminary study. Thromb Res 1985; 37: 459-464
    CrossrefPubMedGoogle Scholar
  • 19 Fitzgerald DJ, Roy L, Catella F, Fitzgerald GA. Platelet activation in unstable coronary disease. N Engl J Med 1986; 315: 983-989
    CrossrefPubMedGoogle Scholar
  • 20 Kiskh YT, Trowbridge EA, Martin JF. Platelet volume subpopulation in acute myocardial infarction: an investigation of their homogeneity for smoking, infarct size and site. Clin Sci 1985; 68: 419-425
    CrossrefPubMedGoogle Scholar
  • 21 Jakubowski JA, Thompson CB, Vaillancourt R, Valeri CR, Deykin D. Arachidonic acid metabolism by platelets of differing size. Br J Haematol 1983; 53: 503-511
    CrossrefPubMedGoogle Scholar
  • 22 Thorngren M, Shafi S, Born GV R. Thromboxane A2 in skin-bleeding-time-blood and in clotted venous blood before and after administration of acetylsalicylic acid. Lancet 1983; 1: 1075-1078
    CrossrefPubMedGoogle Scholar
  • 23 Lewis HD, Davis JW, Archibald DG. et al Protective effect of aspirin against acute myocardial infarction and death in men with unstable angina. Results of Veteran Administration cooperative study N Engl J Med 1983; 309: 396-403
    CrossrefPubMedGoogle Scholar
  • 24 Cairns JA, Gent M, Singer J. et al Aspirin, sulfinpyrazone or both in unstable angina. N Engl J Med 1985; 313: 1369-1375
    CrossrefPubMedGoogle Scholar
  • 25 Thompson CB, Diaz DD, Quinn PG, Lapins M, Kurtz SR, Valeri CR. The role of anticoagulation in the measurement of platelet volumes. Am J Clin Pathol 1983; 80: 327-332
    CrossrefPubMedGoogle Scholar
  • 26 Trowbridge EA, Reardon DM, Hutchinson D, Pickering C. The routine measurement of platelet volume: a comparison of light-scattering and aperture-impedance technologies. Clin Phys Physiol Meas 1985; 06: 221-238
    CrossrefPubMedGoogle Scholar
  • 27 Fagher B, Sjogren A, Sjogren U. Platelet count in myocardial infarction, angina pectoris and peripheral artery disease. Acta Med Scand 1985; 217: 21-26
    PubMedGoogle Scholar
  • 28 Glud T, Schmidt EB, Kristensen SD, Arnfred T. Platelet number and volume during myocardial infarction in relation to infarct size. Acta Med Scand 1986; 220: 401-407
    PubMedGoogle Scholar
  • 29 Thompson CB. Selective consumption of large platelets during massive bleeding. Br Med J 1985; 291: 95-96
    CrossrefPubMedGoogle Scholar
  • 30 Freedman ML, Karpatkin S. Heterogeneity of rabbit platelets. Preferentially splenic sequestration of megathrombocytes Br J Haematol 1975; 31: 255-262
    CrossrefPubMedGoogle Scholar
  • 31 Watson HH K, Ludlam CA. Survival of 111-Indium platelet subpopulations of varying density in normal and post splenectomized subjects. Br J Haematol 1986; 62: 117-124
    CrossrefPubMedGoogle Scholar
  • 32 Martin JF, Penington DG. The relationship between the age and density of circulating 51-Cr-labelled platelets in the sub-human primate. Thromb Res 1983; 30: 157-164
    CrossrefPubMedGoogle Scholar
  • 33 Thompson CB, Love DG, Quinn PG, Valeri CR. Platelet size does not correlate with platelet age. Blood 1983; 62: 487-494
    PubMedGoogle Scholar
  • 34 Savage B, McFaddan PR, Hanson SR, Harker L. The relation of platelet density to platelet age: survival of low-and high-density 111-Indium-labelled platelets in baboons. Blood 1986; 68: 386-393
    PubMedGoogle Scholar
  • 35 Trowbridge EA, Slater DN, Kishk YT, Woodcock BW, Martin JF. Platelet production of myocardial infarction and sudden cardiac death. Thromb Haemostas 1984; 52: 167-171
    PubMedGoogle Scholar
  • 36 Martin JF, Slater DN, Kishk YT, Trowbridge EA. Platelet and megakaryocyte changes in cholesterol-induced experimental atherosclerosis. Arteriosclerosis 1985; 05: 604-612
    CrossrefPubMedGoogle Scholar