Shear stress-induced platelet activation enhances blood coagulation more than adenosine diphosphate-induced activation

Thrombotic complications associated with mechanical circulatory support (MCS) devices are related to both mechanical and chemical stimulation, specifically shear stress and adenosine diphosphate (ADP), which significantly activate platelets. Which of these stimuli is the most critical trigger for blood clotting remains unclear. Consequently, this study aimed to ascertain the effects of platelet activation by shear stress and ADP on plasma fibrin production. In the experiments, platelets were activated by applying a shear stress of 30 Pa for 10 minutes or adding 10 µM ADP to platelet rich plasma. Platelet and plasma samples were collected from each activated batch. Activated platelets were labeled with an anti-CD62P antibody, and platelet activation was confirmed by flow cytometry. The procoagulant response in the plasma samples was initiated using a calcium chloride solution. Fibrin generation was monitored by spectrophotometry, and coagulation time was measured. The results indicated the activation of platelets when subjected to both shear stress and ADP. However, the coagulation time in the plasma after shear stress was significantly shorter than that observed under ADP stimulation. These findings suggest that shear stress-induced platelet activation plays a more significant role in blood coagulation than ADP does.