Systemic and transcardiac platelet behaviour in acute coronary syndromes: the link between platelet physical parameters and platelet function

ABSTRACT

This study investigated the link between platelet physical parameters [platelet count, mean platelet volume, platelet volume distribution and platelet function in vitro [as platelet aggregation] and in vivo [as cutaneous bleeding time]] in twenty patients with unstable angina [UA] and thirty patients with acute myocardial infarction [AMI] on admission and serially for two weeks. Twenty patients with stable angina [SA] and twenty normal volunteers [NV] were used as controls. Ten patients with UA and frequent spontaneous attacks of chest pain were instrumented with left coronary artery and coronary sinus catheters for simultaneous measurements of platelet parameters. Comparison of platelet parameters in coronary arterial and venous blood indicated that large platelets are the likely consumed platelets across the ischemic zone. This was partially response for the lower platelet count, the smaller mean platelet volume, the leftward shift of platelet volume distribution and reduced platelet aggregability in coronary sinus blood. Strikingly, in patients with UA and AMI, garlic intake in a dose of 600 mg tds for two weeks was associated with a consistent increase in platelet count, decrease in platelet volume and leftward shift of volume distribution as well as a concomitant improvement of platelet function. Conversely, patients with AMI who received no garlic showed less significant changes during the follow up period