PMID- 12075265
OWN - NLM
STAT- MEDLINE
DCOM- 20020718
LR  - 20190626
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 143
IP  - 6
DP  - 2002 Jun
TI  - Evaluation of platelets in heart failure: is platelet activity related to 
      etiology, functional class, or clinical outcomes?
PG  - 1068-75
AB  - OBJECTIVES: We sought to determine whether platelet activity in patients with 
      heart failure is related to an ischemic versus nonischemic etiologic condition, 
      clinical disease severity, or adverse clinical outcomes. BACKGROUND: Platelet 
      activity may affect outcome in patients with heart failure. A prospective 
      evaluation of the relation of baseline platelet function to etiologic condition, 
      New York Heart Association (NYHA) class, and clinical outcomes has not been 
      previously reported. METHODS: Ninety-six consecutive outpatients with ambulatory 
      heart failure with an ejection fraction <0.40 and NYHA Class II to IV symptoms 
      who presented to the Duke Heart Failure Clinic and 14 healthy control subjects 
      formed the study groups. Baseline characteristics and blood analyzed for 
      thromboxane (Tx) B2, 6-keto PGF(1alpha), platelet contractile force, adenosine 
      diphosphate/collagen shear-induced closure time, whole blood aggregation and 
      CD41, CD31, CD62p, and CD51/CD61 by flow cytometry were determined. Survival 
      status and hospitalizations were determined in the heart failure patient cohort. 
      RESULTS: The median age of patients was 65 years (22% female, 64% white). An 
      ischemic etiologic condition was present in 61% of patients. The population had 
      mild to moderate heart failure: NYHA class I (1%), II (41%), III (46%), and IV 
      (12.5%) and severe ventricular dysfunction (median ejection fraction = 0.20). 
      There were 39 clinical events (7 deaths, 3 cardiac transplants, 29 other first 
      hospitalizations) in 305 median days of observation. Platelet activity, indicated 
      by whole blood aggregation with 5 micromol adenosine diphosphate (P =.04) and Tx 
      B2 (P =.01), was higher in patients with heart failure. Whole blood aggregation 
      was greater than the 90th percentile in 22% of patients with heart failure versus 
      7% of control subjects. Platelet function did not differ for any of the markers 
      between the ischemic and nonischemic groups and was not affected by antecedent 
      aspirin. There was no relation of NYHA class or the occurrence of events to 
      platelet activity. CONCLUSION: Platelet activity is heightened in 22% of 
      outpatients with stable heart failure symptoms and is not affected by antecedent 
      aspirin therapy. The degree of platelet activation is similar in ischemic and 
      nonischemic patients with heart failure and is not related to clinical disease 
      severity. Current methods to assess platelet activation do not appear to predict 
      outcome.
FAU - Gurbel, Paul A
AU  - Gurbel PA
AD  - Sinai Center for Thrombosis Research, Baltimore, Md 21215, USA. 
      Pgurbel@Sinai-balt.com
FAU - Gattis, Wendy A
AU  - Gattis WA
FAU - Fuzaylov, Sergey F
AU  - Fuzaylov SF
FAU - Gaulden, Laura
AU  - Gaulden L
FAU - Hasselblad, Vic
AU  - Hasselblad V
FAU - Serebruany, Victor L
AU  - Serebruany VL
FAU - O'Connor, Christopher M
AU  - O'Connor CM
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Anticoagulants)
RN  - 61D2G4IYVH (Adenosine Diphosphate)
RN  - R16CO5Y76E (Aspirin)
SB  - IM
MH  - Adenosine Diphosphate/pharmacology
MH  - Aged
MH  - Anticoagulants/administration & dosage
MH  - Aspirin/administration & dosage
MH  - Female
MH  - Heart Failure/*blood/etiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pilot Projects
MH  - *Platelet Activation/drug effects/physiology
MH  - Platelet Aggregation/drug effects/physiology
MH  - Prospective Studies
EDAT- 2002/06/21 10:00
MHDA- 2002/07/19 10:01
CRDT- 2002/06/21 10:00
PHST- 2002/06/21 10:00 [pubmed]
PHST- 2002/07/19 10:01 [medline]
PHST- 2002/06/21 10:00 [entrez]
AID - S0002870302000248 [pii]
AID - 10.1067/mhj.2002.121261 [doi]
PST - ppublish
SO  - Am Heart J. 2002 Jun;143(6):1068-75. doi: 10.1067/mhj.2002.121261.