Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis

Koichi Kawano, Hideaki Yoshino, Nobuo Aoki, Hiroshi Udagawa, Atsushi Watanuki, Yoshiko Hioki, Yukihisa Hasumura, Toshikaki Yasumura, Masashi Homori, Mitsuru Murata, Yasuo Ikeda, Kyozo Ishikawa

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Abstract

Background: Shear stress generated in stenosed arteries promotes platelet thrombi formation at the stenosed sites by accelerating the binding of von Willebrand factor (vWF) to platelets. Shear-induced platelet aggregation (SIPA) has been studied in acute coronary syndromes, but not in chronic coronary disease. Hypothesis: We investigated the effect of both the site and severity of coronary stenosis on SIPA in patients with chronic coronary artery disease. Methods: Shear-induced platelet aggregation was measured using platelet-rich plasma in 49 patients (41 men and 8 women; mean age 61 ± 10 years) with coronary artery disease to evaluate the association between the extent of SIPA and coronary angiographic findings. Stenoses > 75% were considered severe. In all, 62 healthy individuals (54 men and 18 women; mean age 45 ± 7 years) served as controls. The correlation between SIPA and the site and severity of the coronary lesion, and parameters of coagulation and fibrinolysis were evaluated. Results: Shear-induced platelet aggregation was increased in the stenosis group (69.0 ± 10.6%) compared with the controls (57.7 ± 10.3%, p<0.0001). Patients with severe stenosis in the proximal segments had significantly increased SIPA (p < 0.0001) and vWF larger multimer concentration (p < 0.0001) compared with the control group. A significant correlation existed between SIPA and the vWF larger multimer concentration in all subjects studied (r = 0.422, p < 0.0001). Conclusions: Shear-induced platelet aggregation is increased in patients with severe stenosis of the proximal coronary arteries and correlates with plasma concentrations of vWF larger multimers, suggesting that severe stenosis in the proximal segments is not only associated with an increased risk of significant myocardial ischemia, but may also generate high shear stress in the stenosed artery and increase plasma vWF larger multimers, thereby promoting the formation of platelet thrombi.

Original languageEnglish
Pages (from-to)154-160
Number of pages7
JournalClinical Cardiology
Volume25
Issue number4
Publication statusPublished - 2002
Externally publishedYes

Fingerprint

Coronary Stenosis
Platelet Aggregation
von Willebrand Factor
Pathologic Constriction
Blood Platelets
Coronary Artery Disease
Thrombosis
Arteries
Platelet-Rich Plasma
Fibrinolysis
Acute Coronary Syndrome
Myocardial Ischemia
Coronary Disease
Chronic Disease
Binding Sites
Control Groups

Keywords

  • Coronary disease
  • Platelet
  • Stenosis
  • Von Willebrand factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kawano, K., Yoshino, H., Aoki, N., Udagawa, H., Watanuki, A., Hioki, Y., ... Ishikawa, K. (2002). Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis. Clinical Cardiology, 25(4), 154-160.

Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis. / Kawano, Koichi; Yoshino, Hideaki; Aoki, Nobuo; Udagawa, Hiroshi; Watanuki, Atsushi; Hioki, Yoshiko; Hasumura, Yukihisa; Yasumura, Toshikaki; Homori, Masashi; Murata, Mitsuru; Ikeda, Yasuo; Ishikawa, Kyozo.

In: Clinical Cardiology, Vol. 25, No. 4, 2002, p. 154-160.

Research output: Contribution to journalArticle

Kawano, K, Yoshino, H, Aoki, N, Udagawa, H, Watanuki, A, Hioki, Y, Hasumura, Y, Yasumura, T, Homori, M, Murata, M, Ikeda, Y & Ishikawa, K 2002, 'Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis', Clinical Cardiology, vol. 25, no. 4, pp. 154-160.
Kawano K, Yoshino H, Aoki N, Udagawa H, Watanuki A, Hioki Y et al. Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis. Clinical Cardiology. 2002;25(4):154-160.
Kawano, Koichi ; Yoshino, Hideaki ; Aoki, Nobuo ; Udagawa, Hiroshi ; Watanuki, Atsushi ; Hioki, Yoshiko ; Hasumura, Yukihisa ; Yasumura, Toshikaki ; Homori, Masashi ; Murata, Mitsuru ; Ikeda, Yasuo ; Ishikawa, Kyozo. / Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis. In: Clinical Cardiology. 2002 ; Vol. 25, No. 4. pp. 154-160.
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abstract = "Background: Shear stress generated in stenosed arteries promotes platelet thrombi formation at the stenosed sites by accelerating the binding of von Willebrand factor (vWF) to platelets. Shear-induced platelet aggregation (SIPA) has been studied in acute coronary syndromes, but not in chronic coronary disease. Hypothesis: We investigated the effect of both the site and severity of coronary stenosis on SIPA in patients with chronic coronary artery disease. Methods: Shear-induced platelet aggregation was measured using platelet-rich plasma in 49 patients (41 men and 8 women; mean age 61 ± 10 years) with coronary artery disease to evaluate the association between the extent of SIPA and coronary angiographic findings. Stenoses > 75{\%} were considered severe. In all, 62 healthy individuals (54 men and 18 women; mean age 45 ± 7 years) served as controls. The correlation between SIPA and the site and severity of the coronary lesion, and parameters of coagulation and fibrinolysis were evaluated. Results: Shear-induced platelet aggregation was increased in the stenosis group (69.0 ± 10.6{\%}) compared with the controls (57.7 ± 10.3{\%}, p<0.0001). Patients with severe stenosis in the proximal segments had significantly increased SIPA (p < 0.0001) and vWF larger multimer concentration (p < 0.0001) compared with the control group. A significant correlation existed between SIPA and the vWF larger multimer concentration in all subjects studied (r = 0.422, p < 0.0001). Conclusions: Shear-induced platelet aggregation is increased in patients with severe stenosis of the proximal coronary arteries and correlates with plasma concentrations of vWF larger multimers, suggesting that severe stenosis in the proximal segments is not only associated with an increased risk of significant myocardial ischemia, but may also generate high shear stress in the stenosed artery and increase plasma vWF larger multimers, thereby promoting the formation of platelet thrombi.",
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T1 - Shear-induced platelet aggregation increases in patients with proximal and severe coronary artery stenosis

AU - Kawano, Koichi

AU - Yoshino, Hideaki

AU - Aoki, Nobuo

AU - Udagawa, Hiroshi

AU - Watanuki, Atsushi

AU - Hioki, Yoshiko

AU - Hasumura, Yukihisa

AU - Yasumura, Toshikaki

AU - Homori, Masashi

AU - Murata, Mitsuru

AU - Ikeda, Yasuo

AU - Ishikawa, Kyozo

PY - 2002

Y1 - 2002

N2 - Background: Shear stress generated in stenosed arteries promotes platelet thrombi formation at the stenosed sites by accelerating the binding of von Willebrand factor (vWF) to platelets. Shear-induced platelet aggregation (SIPA) has been studied in acute coronary syndromes, but not in chronic coronary disease. Hypothesis: We investigated the effect of both the site and severity of coronary stenosis on SIPA in patients with chronic coronary artery disease. Methods: Shear-induced platelet aggregation was measured using platelet-rich plasma in 49 patients (41 men and 8 women; mean age 61 ± 10 years) with coronary artery disease to evaluate the association between the extent of SIPA and coronary angiographic findings. Stenoses > 75% were considered severe. In all, 62 healthy individuals (54 men and 18 women; mean age 45 ± 7 years) served as controls. The correlation between SIPA and the site and severity of the coronary lesion, and parameters of coagulation and fibrinolysis were evaluated. Results: Shear-induced platelet aggregation was increased in the stenosis group (69.0 ± 10.6%) compared with the controls (57.7 ± 10.3%, p<0.0001). Patients with severe stenosis in the proximal segments had significantly increased SIPA (p < 0.0001) and vWF larger multimer concentration (p < 0.0001) compared with the control group. A significant correlation existed between SIPA and the vWF larger multimer concentration in all subjects studied (r = 0.422, p < 0.0001). Conclusions: Shear-induced platelet aggregation is increased in patients with severe stenosis of the proximal coronary arteries and correlates with plasma concentrations of vWF larger multimers, suggesting that severe stenosis in the proximal segments is not only associated with an increased risk of significant myocardial ischemia, but may also generate high shear stress in the stenosed artery and increase plasma vWF larger multimers, thereby promoting the formation of platelet thrombi.

AB - Background: Shear stress generated in stenosed arteries promotes platelet thrombi formation at the stenosed sites by accelerating the binding of von Willebrand factor (vWF) to platelets. Shear-induced platelet aggregation (SIPA) has been studied in acute coronary syndromes, but not in chronic coronary disease. Hypothesis: We investigated the effect of both the site and severity of coronary stenosis on SIPA in patients with chronic coronary artery disease. Methods: Shear-induced platelet aggregation was measured using platelet-rich plasma in 49 patients (41 men and 8 women; mean age 61 ± 10 years) with coronary artery disease to evaluate the association between the extent of SIPA and coronary angiographic findings. Stenoses > 75% were considered severe. In all, 62 healthy individuals (54 men and 18 women; mean age 45 ± 7 years) served as controls. The correlation between SIPA and the site and severity of the coronary lesion, and parameters of coagulation and fibrinolysis were evaluated. Results: Shear-induced platelet aggregation was increased in the stenosis group (69.0 ± 10.6%) compared with the controls (57.7 ± 10.3%, p<0.0001). Patients with severe stenosis in the proximal segments had significantly increased SIPA (p < 0.0001) and vWF larger multimer concentration (p < 0.0001) compared with the control group. A significant correlation existed between SIPA and the vWF larger multimer concentration in all subjects studied (r = 0.422, p < 0.0001). Conclusions: Shear-induced platelet aggregation is increased in patients with severe stenosis of the proximal coronary arteries and correlates with plasma concentrations of vWF larger multimers, suggesting that severe stenosis in the proximal segments is not only associated with an increased risk of significant myocardial ischemia, but may also generate high shear stress in the stenosed artery and increase plasma vWF larger multimers, thereby promoting the formation of platelet thrombi.

KW - Coronary disease

KW - Platelet

KW - Stenosis

KW - Von Willebrand factor

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