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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation
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Comprehensive Analysis of Procoagulant Platelets Exhibiting Features of Necrosis, Apoptosis and Platelet Activation

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Platelets and cardiac arrhythmia

Jonas S S G de Jong1, Lukas R C Dekker

  • 1Department of Cardiology, Academic Medical Center Amsterdam, Netherlands. jssgdejong@drj.nl

Frontiers in Physiology
|March 23, 2011
PubMed

Insights

Platelets release substances during clot formation that can cause cardiac arrhythmias. Antiplatelet therapy may prevent sudden cardiac death by inhibiting these pro-arrhythmic platelet products.

Area of Science:

  • Cardiology
  • Biochemistry
  • Pharmacology

Background:

  • Sudden cardiac death (SCD) is a leading cause of mortality, primarily due to myocardial ischemia from coronary thrombosis.
  • Platelets play a critical role in SCD, not only through clot formation but also by releasing pro-arrhythmic substances.

Purpose of the Study:

  • To review substances released by platelets during clot formation and their arrhythmic properties.
  • To explore the mechanisms by which platelet products induce cardiac arrhythmias.
  • To discuss the anti-arrhythmic effects of antiplatelet therapy during ischemia.

Main Methods:

  • Review of scientific literature on platelet granule contents and their physiological effects.
  • Analysis of the mechanisms of action of platelet-derived substances on cardiac electrophysiology.
  • Evaluation of evidence for anti-arrhythmic effects of antiplatelet therapy.

Main Results:

  • Platelet dense core granules release serotonin, histamine, purines, and ions that can induce coronary constriction, calcium overload, and after-depolarizations.
  • Alpha-granules release thromboxanes and other arachidonic acid products affecting cardiac ion channels, and proteins that may interact with cardiomyocytes.
  • Lysosomal products have minimal arrhythmic effects; however, platelet products can increase coronary permeability, enhancing cardiomyocyte interaction.

Conclusions:

  • Platelet-derived substances, particularly from dense granules, are significant contributors to cardiac arrhythmias during ischemia.
  • Antiplatelet therapy improves survival post-myocardial infarction not only by preventing thrombosis but also by mitigating ischemia-induced arrhythmias.
  • Targeting platelet activation products offers a potential strategy for managing SCD.

Keywords:
arrhythmiascardiacplateletssudden deathventricular fibrillation

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