open access

Vol 15, No 6 (2008)
Original articles
Published online: 2008-09-22
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Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first ST-segment elevation myocardial infarction: Preliminary report

Marek Koziński, Liliana Bielis, Joanna Wiśniewska-Szmyt, Adam Sukiennik, Zofia Grąbczewska, Iwona Świątkiewicz, Michał Ziołkowski, Danuta Rość, Jacek Kubica
Cardiol J 2008;15(6):530-536.

open access

Vol 15, No 6 (2008)
Original articles
Published online: 2008-09-22

Abstract


Background: Numerous trials have reported on the morning increase in the occurrence of myocardial infarction, stroke and sudden cardiac death. Similarly, enhanced morning platelet aggregation has been observed in healthy individuals and in subjects with coronary artery disease without adequate antiplatelet treatment. The purpose of the study was to assess circadian variation in platelet aggregation in patients with first ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (pPCI) and dual antiplatelet therapy.
Methods: Fifteen consecutive patients (12 men and 3 women) were prospectively recruited into the study. Blood samples were collected at 6.00 a.m., 10.00 a.m., 2.00 p.m. and 7.00 p.m. on the third day of hospitalization. Aggregation in response to arachidonic acid and adenosine diphosphate (ADP) was assessed in the whole blood on a new generation impedance aggregometer.
Results: A morning increase of 75% in ADP-dependent platelet aggregation was noted in the study population (p < 0.04). In contrast, we failed to show any significant diurnal variation in arachidonic acid-mediated platelet aggregation. The magnitude of the morning surge in platelet aggregation after ADP stimulation did not correlate with its baseline level.
Conclusions: Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first STEMI undergoing pPCI. The clinical significance of this finding remains to be demonstrated.

Abstract


Background: Numerous trials have reported on the morning increase in the occurrence of myocardial infarction, stroke and sudden cardiac death. Similarly, enhanced morning platelet aggregation has been observed in healthy individuals and in subjects with coronary artery disease without adequate antiplatelet treatment. The purpose of the study was to assess circadian variation in platelet aggregation in patients with first ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (pPCI) and dual antiplatelet therapy.
Methods: Fifteen consecutive patients (12 men and 3 women) were prospectively recruited into the study. Blood samples were collected at 6.00 a.m., 10.00 a.m., 2.00 p.m. and 7.00 p.m. on the third day of hospitalization. Aggregation in response to arachidonic acid and adenosine diphosphate (ADP) was assessed in the whole blood on a new generation impedance aggregometer.
Results: A morning increase of 75% in ADP-dependent platelet aggregation was noted in the study population (p < 0.04). In contrast, we failed to show any significant diurnal variation in arachidonic acid-mediated platelet aggregation. The magnitude of the morning surge in platelet aggregation after ADP stimulation did not correlate with its baseline level.
Conclusions: Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first STEMI undergoing pPCI. The clinical significance of this finding remains to be demonstrated.
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Keywords

platelet aggregation; circadian variation; antiplatelet therapy; acute myocardial infarction

About this article
Title

Increased morning ADP-dependent platelet aggregation persists despite dual antiplatelet therapy in patients with first ST-segment elevation myocardial infarction: Preliminary report

Journal

Cardiology Journal

Issue

Vol 15, No 6 (2008)

Pages

530-536

Published online

2008-09-22

Bibliographic record

Cardiol J 2008;15(6):530-536.

Keywords

platelet aggregation
circadian variation
antiplatelet therapy
acute myocardial infarction

Authors

Marek Koziński
Liliana Bielis
Joanna Wiśniewska-Szmyt
Adam Sukiennik
Zofia Grąbczewska
Iwona Świątkiewicz
Michał Ziołkowski
Danuta Rość
Jacek Kubica

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