IMPACT OF TREATMENT WITH ACETYLSALICYLIC-ACID ON THE PROAGGREGATORY EFFECTS OF ADRENALINE IN-VITRO IN PATIENTS WITH STABLE ANGINA-PECTORIS - INFLUENCE OF THE ANTICOAGULANT

被引:22
作者
WALLEN, NH
HELD, C
REHNQVIST, N
HJEMDAHL, P
机构
[1] KAROLINSKA HOSP, DEPT CLIN PHARMACOL, S-10401 STOCKHOLM 60, SWEDEN
[2] DANDERYD HOSP, DEPT MED, S-18288 DANDERYD, SWEDEN
[3] KAROLINSKA INST, DEPT PHARMACOL, S-10401 STOCKHOLM 60, SWEDEN
关键词
ACETYLSALICYLIC ACID; ADENOSINE DIPHOSPHATE; ADRENALINE; EXTRACELLULAR CALCIUM; HIRUDIN; ISCHEMIC HEART DISEASE; PLATELET AGGREGATION;
D O I
10.1042/cs0850577
中图分类号
R-3 [医学研究方法]; R3 [基础医学];
学科分类号
1001 ;
摘要
1. The impact of oral acetylsalicylic acid treatment on the enhancing effect of adrenaline on platelet aggregation in vitro was investigated in patients with stable angina pectoris. In addition, the influence of different anticoagulants (i.e. hirudin and citrate) on platelet aggregation in vitro was compared. 2. Eighty-four patients with stable angina pectoris were studied. Sixteen patients were on acetylsalicylic acid treatment (150-250 mg daily), whereas 68 patients were free from acetylsalicylic acid. Platelet-rich-plasma was prepared from citrate- or hirudin-anticoagulated blood. The EC50 (i.e. the concentration of agonist required to produce half-maximal aggregation) for the ADP-induced extent of aggregation was determined. Thereafter the enhancing effect of adrenaline (10 and 50 nmol/l) on ADP-induced aggregation (at EC50) was investigated. 3. In the patients with angina, acetylsalicylic acid caused the expected effects on ADP-induced platelet responses. Adrenaline significantly enhanced both the extent of aggregation and the initial rate of aggregation (primary aggregation), irrespective of the anticoagulant used. In acetylsalicylic acid-treated patients (citrated platelet-rich plasma) the extent of aggregation was partly inhibited, but no significant effect on the rate of aggregation could be observed. 4. A comparative substudy of the anticoagulants in healthy subjects (n=8) showed that both the aggregating effect of ADP per se and the enhancing effect of adrenaline on ADP-induced aggregation (at EC50) were less influenced by acetylsalicylic acid when evaluated in hirudinized platelet-rich plasma (i.e. with physiological levels of extracellular calcium) as compared with citrated platelet-rich plasma. 5. It is concluded that acetylsalicylic acid treatment slightly attenuates the proaggregatory effect of high physiological concentrations of adrenaline in vitro. The impact of acetylsalicylic acid in vitro is, however, strongly dependent on the anticoagulant used, and is significantly weaker when evaluated in a medium with normal extracellular calcium levels (i.e. hirudin) than in a medium with low levels of extracellular calcium (citrate). Thus, acetylsalicylic acid may be a weak antagonist of catecholamine-induced platelet activation in vivo.
引用
收藏
页码:577 / 583
页数:7
相关论文
共 30 条
[11]   DOUBLE-BLIND TRIAL OF ASPIRIN IN PRIMARY PREVENTION OF MYOCARDIAL-INFARCTION IN PATIENTS WITH STABLE CHRONIC ANGINA-PECTORIS [J].
JUULMOLLER, S ;
EDVARDSSON, N ;
JAHNMATZ, B ;
ROSEN, A ;
SORENSEN, S ;
OMBLUS, R .
LANCET, 1992, 340 (8833) :1421-1425
[12]  
LAGES B, 1981, THROMB HAEMOSTASIS, V45, P173
[13]  
LALAUKERALY C, 1988, THROMB HAEMOSTASIS, P209
[14]   EPINEPHRINE POTENTIATES HUMAN-PLATELET ACTIVATION BUT IS NOT AN AGGREGATING AGENT [J].
LANZA, F ;
BERETZ, A ;
STIERLE, A ;
HANAU, D ;
KUBINA, M ;
CAZENAVE, JP .
AMERICAN JOURNAL OF PHYSIOLOGY, 1988, 255 (06) :H1276-H1288
[15]   ALTERED PLATELET-FUNCTION DURING MENTAL STRESS AND ADRENALINE INFUSION IN HUMANS - EVIDENCE FOR AN INCREASED AGGREGABILITY INVIVO AS MEASURED BY FILTRAGOMETRY [J].
LARSSON, PT ;
HJEMDAHL, P ;
OLSSON, G ;
EGBERG, N ;
HORNSTRA, G .
CLINICAL SCIENCE, 1989, 76 (04) :369-376
[16]   ALPHA-ADRENOCEPTOR BLOCKADE BY PHENTOLAMINE INHIBITS ADRENALINE-INDUCED PLATELET ACTIVATION INVIVO WITHOUT AFFECTING RESTING MEASUREMENTS [J].
LARSSON, PT ;
WALLEN, NH ;
EGBERG, N ;
HJEMDAHL, P .
CLINICAL SCIENCE, 1992, 82 (04) :369-376
[17]  
LARSSON PT, 1993, THROMB HAEMOSTASIS, V69, P635
[18]   SHEAR-INDUCED PLATELET-AGGREGATION [J].
OBRIEN, JR .
LANCET, 1990, 335 (8691) :711-713
[19]  
PACKHAM MA, 1989, THROMB HAEMOSTASIS, V62, P968
[20]  
PACKHAM MA, 1987, BLOOD, V70, P647