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In vivo platelet activation following myocardial infarction and acute coronary ischaemia.

Forty-seven patients presenting with acute chest pain had in vivo platelet activity assessed by measuring plasma levels of the platelet-specific protein beta thromboglobulin (BTG), and by screening for the presence of circulating platelet aggregates. Nineteen patients with transmural myocardial infarction (MI), 21 patients with acute coronary ischaemia (CI), and 7 patients with non-cardiac chest pain (NCCP) were investigated in a serial study and compared with a normal control group. The means of all BTG determinations in the MI (34, +/- SD = 21-57) and CI (33, +/- SD = 19-57) groups were significantly higher than those in the NCCP group (24, +/- SD equal 17-34; p less than 0.01) and normal subjects (22,5 +/- SD = 14-37; p less than 0.001). There was no difference in BTG between those with MI or CI, nor between the NCCP group and normal subjects. Raised numbers of circulating platelet aggregates could not be detected in either MI or CI. The mean BTG levels in both MI and CI patients were significantly raised, compared to normal subjects, on the first day of admission to hospital and remained so on each of the subsequent nine days. Neither heparin plus warfarin nor sulphinpyrazone had any significant effect in lowering BTG levels. 15/40 patients (37.5%) following MI and CI had repeatedly raised BTG levels throughout the study period, and it is suggested that these patients represent an "at risk" group that may benefit from anti-platelet therapy in secondary prevention studies.

Acute Disease↗

The thrombogenicity of Dacron arterial grafts and its modification by platelet inhibitory drugs.

When blood flows through Dacron arterial grafts, platelets adhere in large numbers to the luminal surface of the grafts. Different types of commercially available Dacron grafts vary in their level of thrombogenicity. This thrombogenic response has been evaluated in an artificial circulation and in patients with Dacron aorto-bifemoral grafts, and the response can be modified by the use of platelet-inhibitory drugs. A double blind trial has shown that when a combination of aspirin and dipyridamole is administered to patients with femoro-popliteal Dacron bypass grafts, then the patency rate of these grafts can be significantly improved.

Arteries↗