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Published on: June 10, 2025
Platelet reactivity among Asian Indians and Caucasians
Rajnikant T Patel1, Eli I Lev, Muthiah Vaduganathan
1Division of Cardiology, Baylor College of Medicine, Houston, TX, USA.
Insights
Asian Indians exhibit heightened platelet reactivity, indicated by increased P-selectin expression and platelet-leukocyte aggregate formation. These findings may explain higher coronary artery disease rates in this ethnic group.
Area of Science:
- Cardiovascular Science
- Hematology
- Ethnic Health Disparities
Background:
- Asian Indians experience disproportionately higher rates of coronary artery disease (CAD) mortality and morbidity compared to other ethnicities.
- Conventional risk factors do not fully account for these observed disparities in cardiovascular events.
- Platelet activation is a critical factor in CAD pathogenesis, yet data on platelet reactivity in Asian Indians are limited.
Purpose of the Study:
- To investigate and compare platelet reactivity between healthy Asian Indians and Caucasians.
- To identify potential ethnic-specific differences in platelet function that may contribute to CAD risk.
Main Methods:
- Matched cohort study comparing 35 healthy Asian Indians and 35 healthy Caucasians.
- Assessed platelet aggregation, P-selectin expression (induced by ADP, TRAP, AA), and platelet-leukocyte aggregate (PLA) formation via flow cytometry.
- Measured P-selectin glycoprotein ligand-1 (PSGL-1) density on leukocytes.
Main Results:
- No significant differences were found in platelet aggregation, basal PLA, or PSGL-1 density between groups.
- Arachidonic acid (AA)-stimulated P-selectin expression was significantly higher in Asian Indians (P < 0.02).
- Thrombin receptor agonist peptide (TRAP)-stimulated PLA formation was significantly increased in Asian Indians compared to Caucasians (P < 0.02).
Conclusions:
- Asian Indians demonstrate elevated platelet reactivity, specifically in AA-induced P-selectin expression and TRAP-stimulated PLA formation.
- These heightened platelet activation markers in Asian Indians may offer a molecular explanation for their increased susceptibility to cardiovascular disease.
- Findings underscore the importance of considering ethnic-specific variations in platelet function for cardiovascular risk assessment.
Abstract:
Asian Indians are reported to have higher mortality and morbidity from coronary artery disease (CAD) than other ethnic groups. This variation in events cannot be explained only by differences in conventional risk factors. Platelet activation is an important factor in the pathogenesis of CAD, however, there are limited data concerning platelet reactivity in Asian Indians. Therefore, we aimed to examine platelet reactivity in healthy Asian Indians vs. Caucasians. Thirty-five healthy, nonsmoking Asian Indians (mean age 30.1 +/- 3.6 years, 31.4% women) were matched for age and sex with 35 healthy, nonsmoking Caucasians (mean age 30.8 +/- 5 years, 31.4% women). Platelet reactivity was evaluated by measuring platelet aggregation, platelet leukocyte aggregates (PLA) formation in response to a 6-mer thrombin receptor agonist peptide (TRAP) at a final concentration of 40 microM and flow cytometry determined P-selectin expression induced by ADP, TRAP and arachidonic acid (AA). In addition, P-Selectin glycoprotein ligand-1 (PSGL-1) density on leukocytes was measured. There were no differences in platelet aggregation, basal PLA or PSGL-1 density on leukocytes between the two groups. AA-stimulated P-selectin expression was significantly higher in Asian Indians than in Caucasians (6.1 +/- 0.51 vs. 4.2 +/- 0.41 MFI, P < 0.02). After stimulation with TRAP, platelets from Asian Indians had increased PLA formation compared with Caucasians (41.6 +/- 2.9% vs. 31.4 +/- 2.7%, P < 0.02). AA induced P-selectin expression and TRAP stimulated PLA formation is increased in Asian Indians compared with Caucasians. These differences indicate an increase in measures of platelet reactivity among Asian Indians and may help elucidate the reported disparity in cardiovascular disease rates between the two ethnic groups.
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