Dietetics, Nutrition and Biological Sciences
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Item Functional interplay between platelet activation and endothelial dysfunction in patients with coronary heart disease(Taylor & Francis, 2006-05) Davidson, Isobel; Robinson, S. D.; Harding, S. A.; Cummins, P.; Din, J. N.; Sarma, J.; Fox, K. A. A.; Boon, N. A.; Newby, D. E.Platelet-monocyte binding and surface P-selectin expression are sensitive markers of platelet activation. Endothelium-derived factors are known to inhibit platelet activation and may confer important anti-atherothrombotic effects. We assessed the relationship between platelet activation and endothelium-dependent vasomotion in patients with coronary heart disease (CHD). Twenty male patients with stable CHD were compared with 20 healthy men. Platelet-monocyte binding and platelet surface expression of P-selectin were assessed using two-colour flow cytometry on whole blood. Forearm blood flow was assessed in patients using venous occlusion plethysmography during intra-arterial infusions of substance P, acetylcholine and sodium nitroprusside. Platelet activation was higher in patients than healthy men (platelet-monocyte binding, 27--3 vs. 20--1%; P-<-0.05). In patients with CHD, there was an inverse correlation between maximal substance P induced vasodilatation and both platelet-monocyte binding (P-=-0.003) and P-selectin expression (P-=-0.02). A similar correlation was observed between platelet-monocyte binding and the vasomotor response to acetylcholine (P-=-0.08) but not with sodium nitroprusside. In patients with stable coronary heart disease, there is a strong inverse relationship between markers of platelet activation and endothelium-dependent vasomotor function. This may explain the pathophysiological mechanism linking endothelial vasomotor dysfunction and the risk of acute atherothrombotic events.