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[Evaluation of platelet function and tissue plasminogen activator activity in ischemic heart disease depending on
M Jastrzebska1, B Torbus-Lisiecka, J Pieczul-Mróz
1Zakład Biochemii Klinicznej i Diagnostyki Laboratoryjnej Pomorskiej Akademii Medycznej, Szczecinie.
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Aspirin therapy benefits patients with ischemic heart disease (IHD) and hyperlipoproteinemia (HLP) by reducing platelet activation and improving fibrinolysis. However, it did not significantly lower platelet factor 4 (PF4) levels in these patients.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biochemistry
Background:
- Ischemic heart disease (IHD) pathogenesis involves platelet activation, impaired fibrinolysis, and dyslipidemia.
- Platelet activation markers include spontaneous platelet activation (SPA), platelet factor 4 (PF4), and plasminogen activator inhibitor 1 (PAI-1).
- Hyperlipoproteinemia (HLP) is a common comorbidity in IHD patients.
Purpose of the Study:
- To investigate the effects of aspirin on platelet activation and fibrinolysis in patients with IHD, with or without HLP.
- To assess the relationship between lipid profiles and hemostatic parameters in IHD patients.
Main Methods:
- Study included 57 IHD patients (with and without HLP) and 21 healthy controls.
- Measured plasma levels of SPA, PF4, PAI-1, and lipid fractions (TC, TG, LDL, HDL).
- Assessed PAI-1 activity after in vitro platelet stimulation.
Main Results:
- All IHD groups showed elevated PF4 levels, regardless of HLP or aspirin treatment.
- Patients with IHD and HLP without aspirin exhibited increased SPA and PAI-1.
- Aspirin treatment reduced PAI-1 levels, particularly after platelet stimulation, and inhibited SPA, but did not significantly lower PF4.
Conclusions:
- Patients with IHD and HLP have heightened platelet activation and impaired fibrinolysis.
- Aspirin demonstrates a beneficial effect on these parameters in IHD patients, primarily by reducing PAI-1 release and SPA.
- Aspirin's efficacy in reducing PF4 levels in IHD patients requires further investigation.
Abstract:
Platelet activation, impairment of fibrinolysis and dyslipidemia are important factors in the pathogenesis and progression of ischemic heart disease. Aspirin therapy will reduce platelet activation both by its negative effect on platelet aggregation (SPA) and by inhibition of granule release which liberates such mediators as platelet factor 4 (PF4) and plasminogen activator inhibitor 1 (PAI-1). The present study was performed in 57 patients with ischemic heart disease (IHD), divided into groups depending on coexistent hyperlipoproteinemia (HLP) and aspirin treatment. The control group included 21 healthy individuals, matched for age and sex. Parameters of hemostasis (SPA, PF4, PAI-1) and concentration of lipid fractions (TC, TG, LDL, HDL) were measured in plasma. Increased PF4 levels were found in all groups with IHD, irrespective of hyperlipoproteinemia or aspirin treatment. Enhanced SPA and higher PAI-1 were limited to group IHD-HLP without aspirin. Highest PAI-1 activities were observed after stimulation of platelets in vitro. In conclusion, patients with IHD and hyperlipoproteinemia presented most pronounced platelet activation and impairment of fibrinolysis. Aspirin had a beneficial effect on these changes. Lower activities of PAI-1, in patients treated with aspirin, can be ascribed to its reduced release from platelets. Aspirin did not satisfactorily reduce the level of PF4, although it strongly inhibited SPA.