Circulation, Vol 83, 38-44, Copyright © 1991 by American Heart Association
PC Elwood, S Renaud, DS Sharp, AD Beswick, JR O'Brien and JW Yarnell
The Caerphilly Collaborative Heart Disease Study is based on a large cohort
of men (2,398) aged 49-66 years at the time of study. Platelet aggregation
induced by collagen, thrombin, and ADP was measured in fasting blood
samples and was related to prevalent angina, past myocardial infarction,
and electrocardiographic evidence of ischemic heart disease. A number of
subjects had taken aspirin, other nonsteroidal anti-inflammatory drugs, or
other drugs affecting platelet aggregation 7 days before blood sample
collection; after the exclusion of these subjects, data were available for
1,811 men. No relations were demonstrated with angina, but significant
relations were shown between past myocardial infarctions and
electrocardiographic evidence of ischemia and ADP-induced aggregation (both
primary and secondary) and between electrocardiographic evidence of
ischemia and thrombin-induced aggregation. The strongest relation indicated
more than a twofold increase in the odds of a past myocardial infarction in
subjects of the highest fifth of ADP-induced primary platelet aggregation
compared with the lowest fifth. No significant relations were detected with
collagen- induced aggregation. Accounting for a number of possible
confounding factors had a relatively small impact on the relations between
platelet aggregation and ischemic heart disease. Other evidence, including
the well-established effect of aspirin on reducing the incidence of
ischemic heart disease, indicates that the relations we describe are
unlikely to be simply an effect of IHD on platelets.
ARTICLES
Ischemic heart disease and platelet aggregation. The Caerphilly Collaborative Heart Disease Study
Medical Research Council Epidemiology Unit, Cardiff, United Kingdom.
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