Abstract-Platelet aggregation is inhibited through a negative feedback mechanism by the L-arginine/nitric oxide (NO) pathway found in platelets themselves. We have shown that long-term smoking impairs the bioactivity of platelet-derived NO (PDNO), resulting in an increased platelet aggregability. However, little is known about the relation between other coronary risk factors and PDNO release. Accordingly, this study was undertaken to examine whether other coronary risk factors are related to the impairment of PDNO bioactivity. We measured collagen-induced PDNO release with an NO-selective electrode in 61 subjects (mean age 47 years, range 24 to 74 years) who underwent complete physical and laboratory examinations. There was a significant inverse correlation between PDNO release and the number of coronary risk factors (rϭϪ0. Key Words: platelets Ⅲ nitric oxide Ⅲ risk factors Ⅲ atherothrombosis P latelets possess the functional L-arginine/nitric oxide (NO) pathway via constitutive NO synthase. 1,2 Platelet-derived NO (PDNO) increases the intraplatelet level of cGMP and inhibits platelet aggregation. 1 This modulation of platelet aggregation via the L-arginine/NO pathway is recognized as a negative-feedback mechanism to inhibit aggregation. 3,4 Using an NO-selective electrode, we 5 and others 6 directly measured PDNO release during platelet aggregation, which was potentiated by L-arginine and attenuated by inhibitors of NO synthase, indicating the existence of an L-arginine/NO pathway in human platelets. 1,7 PDNO has been shown to play a functional role in the inhibition of not only platelet activation but also platelet recruitment after aggregation. 8 Recently, we have shown that long-term smoking impairs PDNO release, resulting in an increased platelet aggregability. 5 However, little is known about the relation between other coronary risk factors and PDNO release. Accordingly, the present study was undertaken to investigate the hypothesis that other coronary risk factors impair platelet function and thereby affect PDNO release in subjects with major risk factors.
Methods
Study SubjectsThe study population consisted of 61 subjects who agreed to participate in the study. The subjects underwent complete routine physical and laboratory examinations, and their complete anamnesis was obtained. Of the 61 subjects, 42 were healthy volunteers, 12 had stable effort angina, and 7 had previous myocardial infarction. Medications, including long-acting nitrates, calcium channel blockers, -blockers, and ACE inhibitors, were withheld for Ն24 hours, and aspirin was withheld for Ն1 week before the study. None of the patients had received cholesterol-lowering agents. Patients with acute coronary syndromes, valvular heart diseases, or heart failure were excluded from the study. The present protocol was approved by our institutional ethic committee, and informed consent for the study was obtained from all patients.
Definition of Coronary Risk FactorsCoronary risk factors in this study were determined according to the Sixth Report o...