[Platelet hyperaggregation premonitory of myocardial infarct? A clinical case report]

In a patient, treated with antiplatelet drugs because of two previous TIA episodes, an occasional control in apparent welfare, just 4 hours before the onset an IMA, showed a sudden considerable increase of spontaneous aggregation. Two weeks after the infarction all haematological findings, including aggregation, were back to normal. Platelet adhesiveness, evaluated for the first time, was nevertheless considerably increased. A treatment with an association of low doses of acenocoumarine and ASA was useful to take aggregation and adhesiveness firmly back to normal values that persist 22 month after the episode. Spontaneous platelet hyperadhesion, occasionally recorded a few hours before IMA, bears out the importance of the role played by platelets in vascular coronary accident. Authors suggest that it is therefore advisable to evaluate platelet adhesiveness too, regardless of the specific meaning of this test; it is worth investigating whether this monitoring should lead to some attempt whatsoever enabling to prevent recurrent crisis, adding to antiaggregant therapy, a management with anticoagulating drugs, administered with low dosage.