Key result
Patients with effort angina had a significantly higher platelet retention rate under high shear stress compared to healthy controls (10.9% vs 5.6%, P < .01), despite ticlopidine treatment.
Why the study?
Do patients with effort angina on aspirin and ticlopidine exhibit abnormal platelet and leukocyte activation under high shear stress compared to healthy controls?
Case-Control (n=43)
Do patients with effort angina on aspirin and ticlopidine exhibit abnormal platelet and leukocyte activation under high shear stress compared to healthy controls?
High shear stress causes abnormal activation of leukocytes and platelets in effort angina patients, which is not fully suppressed by standard dual antiplatelet therapy with aspirin and ticlopidine.
Answers are grounded in this paper and cite their sources.
May indicate incomplete shear-induced platelet suppression by DAPT in effort angina; hypothesis-generating and requires prospective validation.
This study used a small-sized collagen bead column system to investigate platelet functions under high shear stress in 28 patients with effort angina and 15 healthy controls. Soluble P-selectin and soluble L-selectin were also evaluated. Patients underwent stent insertion, followed by treatment with aspirin (100 mg/day) and ticlopidine (200 mg/day). High-shear-dependent platelet function was measured using small-sized collagen beads. The retention rate of platelets from patients with angina was higher than that in healthy controls (10.9% +/- 3.9% versus 5.6% +/- 1.7%, P < .01). Soluble P-selectin and soluble L-selectin levels of patients with angina significantly increased after passage through the columns. Levels of soluble P-selectin and L-selectin in healthy controls did not exhibit significant changes with passage through the columns. These results suggested that high shear stress caused abnormal activation of leukocytes or adhesive proteins in patients with effort angina, and ticlopidine failed to suppress hyperaggregability of platelets in these patients.
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Inami et al. (2007) conducted a case-control in Effort angina (n=43). Effort angina vs. Healthy controls was evaluated on Platelet retention rate under high shear stress (p=< .01). Patients with effort angina had a significantly higher platelet retention rate under high shear stress compared to healthy controls (10.9% vs 5.6%, P < .01), despite ticlopidine treatment.
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