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Bleeding time, stroke and myocardial infarction: the Caerphilly prospective study
P C Elwood1, Janet Pickering, J Yarnell
1University of Wales College of Medicine, Wales, UK. pelwood@doctors.org.uk
Platelets
|July 10, 2003
Summary
The stressed bleeding time test, a measure of haemostasis, does not predict myocardial infarction or ischaemic stroke in older men. This study indicates it has no role in health screening for vascular disease events.
Area of Science:
- Cardiovascular Medicine
- Haemostasis Research
- Epidemiology
Background:
- The stressed bleeding time is a global haemostasis test assessing platelet function, rheology, thrombosis, and intimal function.
- Its clinical value is contingent on its predictive capacity for vascular disease events.
- Previous research has not definitively established its prognostic utility.
Purpose of the Study:
- To evaluate the predictive value of the stressed bleeding time for myocardial infarction (MI) and ischaemic stroke.
- To determine if stressed bleeding time can serve as a screening tool for vascular disease.
Main Methods:
- A cohort of 1319 men aged 55-69 years underwent stressed bleeding time testing.
- Participants were followed for 7-10 years for incident MI and ischaemic stroke.
- Statistical analyses adjusted for confounding factors to assess relative odds (ROs).
Main Results:
- The mean bleeding time was 323 seconds; shorter in smokers and longer in aspirin users.
- The RO for MI in the longest bleeding time tertile was 0.90 (0.40-2.03).
- The RO for ischaemic stroke in the longest bleeding time tertile was 1.42 (0.39-5.21).
Conclusions:
- The stressed bleeding time test does not predict myocardial infarction or ischaemic stroke in this cohort.
- The test lacks utility for health screening of vascular disease events.
- Further research into predictive haemostasis markers may be warranted.