Erythrocyte promotion of platelet reactivity decreases the effectiveness of aspirin as an antithrombotic therapeutic modality.
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Biomedical subjects
Publications and source records attributed to I A Jagroop.
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BACKGROUND: Lipid lowering drugs improve survival. However, intervention studies have focused on reducing serum total cholesterol and low density lipoprotein (LDL) concentrations and have not considered that levels of high density lipoprotein (HDL), triglycerides (TG), lipoprotein (a) and fibrinogen also predict risk and outcome. METHODS: A retrospective survey of patients with primary dyslipidaemia attending a cardiovascular risk management clinic (set in a university hospital) was initiated to assess the effect of ciprofibrate, a drug with the potential to modify all these variables. Patients who received ciprofibrate (n = 72) were compared with 64 patients who only received lifestyle advice. Both groups had a similar age and gender distribution. The ciprofibrate group had a higher cardiovascular risk load but both groups shared several other characteristics. Fasting serum total cholesterol, LDL, HDL, TG, lipoprotein (a), glucose and plasma fibrinogen concentrations were measured at baseline and after 2-4 months. RESULTS: Ciprofibrate significantly improved total cholesterol, LDL, HDL, TG, lipoprotein (a) and fibrinogen. In contrast, lifestyle advice only significantly (but less markedly) reduced serum total cholesterol and TG concentrations. CONCLUSIONS: In a clinical setting, ciprofibrate has a broad spectrum of action on several predictors of vascular events. Although our study is not of a double blind randomized design it reflects the conditions in clinical practice. Nevertheless, this type of survey has its limitations.
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Therapeutic concentrations, added in vitro, of a low molecular weight heparin (LMWH), nadroparin (Fraxiparine), inhibit thrombin-induced platelet shape change (PSC), an early stage of human platelet activation. PSC was monitored by measuring the median platelet volume (MPV) using a high resolution channelyzer. The inhibitory action of nadroparin was specific to thrombin since this LMWH did not influence PSC induced by other agonists. In whole blood, unfractionated heparin (UH) but not nadroparin, significantly enhanced spontaneous platelet aggregation and increased MPV when compared with LMWH or saline controls. In conclusion, the LMWH, nadroparin, exerts less platelet activation than UH.
We have investigated the effects of chronic physical training and acute intensive exercise on plasma fibrinogen levels and the relationship of these responses to beta-fibrinogen G-453-A polymorphism genotype. One hundred fifty-six male British Army recruits were studied at the start of their 10-week basic training, which emphasizes physical fitness. Cohorts were restudied between 0.5 and 5 days after a major 2-day strenuous military exercise (ME) undertaken in their final week of training. Changes in fibrinogen concentration were adjusted for the effects of age, body mass index, and smoking history. Compared with baseline values, fibrinogen concentrations were significantly lower (11.9%, P=.04) at day 5 after ME, consistent with the beneficial effect of training. However, they were higher on days 1 through 3 after ME (suggesting an "acute-phase" response to strenuous exercise) and were maximal on days 1 and 2 (27.2%, P<.001 and 37.1%, P<.001 respectively). Fibrinogen genotype was available in 149 individuals. As expected from previous studies, men with one or more fibrinogen gene A-453 alleles had plasma fibrinogen concentration slightly but significantly higher at baseline (4.5%, P=.11). During the acute-phase response (days 2 and 3), however, the degree of rise was strongly related to the presence of the A allele, being 26.7+/-5.4% (mean+/-SE), 36.5+/-11.0%, and 89.2+/-30.7 for the GG, GA, and AA genotypes, respectively (P=.01). These results confirm that chronic exercise training lowers plasma fibrinogen levels, that intensive exercise generates an acute-phase rise in levels, and that this acute response is strongly influenced by the G/A polymorphism of the beta-fibrinogen gene.
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Angioplasty and bypass-grafting are associated with restenosis which limits their efficacy. Platelet-rich thrombus formation is the predominant cause of acute occlusion whereas platelet release products with proliferating properties, e.g. 5-hydroxytryptamine (5-HT) and platelet-derived growth factor (PDGF), may contribute to late restenosis. Naftidrofuryl (NAF), a drug for the treatment of peripheral vascular disease, was shown previously to inhibit platelet shape change and aggregation. This study establishes whether NAF inhibits the release of 5-HT and PDGF from platelets obtained from healthy subjects. Platelets stimulated with agonists aggregated less and released less 5-HT/PDGF when pre-incubated with NAF. Indomethacin (INDO), a cyclooxygenase inhibitor, alone inhibited aggregation and PDGF/5-HT release; NAF enhanced the inhibitory effects of INDO. The effect of NAF, on its own or in combination with a cyclooxygenase inhibitor, may therefore confer protection against graft occlusion.