Platelet tests in the prediction of myocardial infarction and ischaemic stroke: evidence from the Caerphilly Prospective Study

Elwood, Peter Creighton; Beswick, Andrew D; Pickering, Janet Elizabeth; McCarron, Peter; O’Brien, J.R.; Renaud, S.; Flower, Rod

doi:10.1046/j.1365-2141.2001.02728.x

Cited by 38 publications

(33 citation statements)

References 33 publications

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“…The biological significance of our observations remains to be determined. The participation of platelets is crucial in arterial thrombotic events, but ex vivo platelet aggregation tests do not predict risk for future CV events (Elwood et al, 1998(Elwood et al, , 2001. So, the increased wine-related platelet aggregation=secretion reactions detected here do not denote an increased risk of CV events.…”

Section: Beneficial Changes In Haemostasismentioning

confidence: 68%

Mediterranean diet, but not red wine, is associated with beneficial changes in primary haemostasis

et al. 2003

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Objective: (1) To compare the effect of an alcohol-free Mediterranean-type diet (MD) and a high-fat diet (HFD) on variables of primary haemostasis (bleeding time, plasma von Willebrand factor and platelet aggregation=secretion). (2) To test whether red wine supplementation modified these variables, independently of the diet. Design, subjects and intervention: Controlled prospective intervention study. Two groups, each consisting of 21 healthy male university students (22 AE 3.4 y), received either MD or HFD during 90 days. Between days 30 and 60, both diets were supplemented with 240 ml=day of red wine. Baseline (T0) and T30, T60 and T90-day samples were drawn. Bleeding time was measured before (day 30) and after (day 60) wine supplementation. No drop out from the study was experienced. Setting: University campus and outpatient nutrition clinic. Results: All baseline (day 0) variables did not differ significantly between study groups. On day 30, individuals on MD had significantly higher levels of plasma b-carotene, folate, ascorbate, and eicosapentaenoic acid in plasma lipid fractions, than those on HFD. Total plasma cholesterol, HDL and LDL did not change significantly in either study group at any time point. After 30 days on each diet, individuals on MD had longer bleeding time (BT) than those on HFD (7.6 AE 2.8 vs 5.8 AE 1.7 min; P ¼ 0.017). BT did not change significantly after I month of wine supplementation (7.1 AE 2.0 vs 5.5 AE 2.0 min, respectively). Plasma von Willebrand factor (vWF : Ag) on day 0 was 89 AE 40 and 111 AE 70% in MD and HFD groups, respectively (P ¼ 0.21). These values did not change significantly at 30, 60 or 90 days. MD intake was associated with an increase in platelet serotonin secretion (P ¼ 0.02) and a marginal increase in platelet aggregation after stimulation with epinephrine (P ¼ 0.07). Wine intake resulted in a marginal decrease in platelet 14 C-5-HT secretion with 4 mM ADP (P ¼ 0.07). However, both platelet aggregation and secretion were consistently increased when using collagen as agonist (1 and 2 mg=ml, P ¼ 0.01). Conclusion: The longer BT in individuals on MD, obtained independently of red wine, denotes less interaction of platelets with the vascular wall, which could be beneficial from the point of view of cardiovascular (CV) risk. This effect is not explained by changes in the measured haemostatic determinants of BT (plasma vWF, ex vivo platelet function), and might be attributed to other as yet unknown vascular factors. Moderate consumption of red wine results in a significant increase in ex vivo platelet aggregation and secretion after stimulation with collagen. This observation contradicts previous reports, although further studies are required to elucidate the influence of this finding on CV risk.

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Section: Beneficial Changes In Haemostasismentioning

confidence: 68%

Mediterranean diet, but not red wine, is associated with beneficial changes in primary haemostasis

et al. 2003

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“…Evidence on prevalent vascular disease, ischaemic heart disease and/or stroke, including a 12-lead ECG, was recorded. Samples of fasting blood were taken for estimation of platelet (Elwood et al, 2001a), haemostatic (Baker et al, 2002), rheological (Elwood et al, 2001b), lipids (Yarnell et al, 2001), psychosocial (Gallacher et al, 1999) and other factors of possible relevance to vascular disease.…”

Section: Methodsmentioning

confidence: 99%

Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort

et al. 2004

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Objective: To test the hypothesis that milk drinking increases the risk of ischaemic heart disease (IHD) and ischaemic stroke in a prospective study. Design: In the Caerphilly Cohort Study dietary data, including milk consumption, were collected by a semiquantitative food frequency questionnaire in [1979][1980][1981][1982][1983]. The cohort has been followed for 20-24 y and incident IHD and stroke events identified. Subjects: A representative population sample in South Wales, of 2512 men, aged 45-59 y at recruitment. Main outcome measures: In total, 493 men had an IHD event and 185 an ischaemic stroke during follow-up. Results: After adjustment, the hazard ratio in men with a milk consumption of one pint (0.57 l) or more per day, relative to men who stated that they consumed no milk, is 0.71 (0.40-1.26) for IHD and 0.66 (0.24-1.81) for ischaemic stroke. At baseline, 606 men had had clinical or ECG evidence of vascular disease, and in these the vascular risk was even lower (0.37; 0.15-0.90). The hazard ratio for IHD and ischaemic stroke combined is 0.64 (0.39-1.06) in all men and 0.37 (0.15-0.90) in those who had had a prior vascular event. Conclusion: The data provide no convincing evidence that milk consumption is associated with an increase in vascular disease risk. Evidence from an overview of all published cohort studies on this topic should be informative. Sponsorship:

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“…Two small studies have suggested that platelet aggregability assessed by a light transmittance aggregometer could be predictive of cardiovascular events 37,38) ; however, the Northwick Park Heart Study, a large cohort study consisting of 740 men followed up for 10.1 years, found no association of ADP-induced aggregation with ischemic heart disease events 19) . In the Caerphilly Prospective Study, consisting of 2000 elderly men followed up for 10 years, the aggregative response to ADP in platelet- rich plasma, that to ADP in whole blood measured using an impedance method, and platelet aggregation induced in whole blood by high-shear flow did not show an association with myocardial infarction 3) . In this study, we found that the platelet count and platelet aggregation are affected by factors such as gender, age, and lipid levels in the Japanese population.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, higher fibrinogen levels were associated with increased epinephrineinduced aggregation and a tendency to word ADPinduced aggregation 8) . Evidence suggests that increased platelet reactivity could identify individuals at risk for atherothrombotic diseases; however, large cohort studies, including the Northwick Park Heart Study and the Caerphilly Prospective Study, did not show an association of platelet aggregability with cardiovascular events 3,19) . Studies on the variability of platelet responsiveness to agonists have been mainly performed in the Caucasian population; studies in the Asian population are very limited.…”

Section: Introductionmentioning

confidence: 99%

Association of Platelet Aggregation with Lipid Levels in the Japanese Population: the Suita Study

Kameda

Sakata

Kokubo

et al. 2011

JAT

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Aim: Platelets play a pivotal role in atherothrombotic diseases. Platelet aggregability induced by agonists has great interindividual variability; however, the factors influencing platelet aggregability variation have not been characterized in Asia. Methods: To examine the confounding factors influencing platelet counts and responsiveness to agonists, we measured the platelet counts and platelet aggregability induced by 1.7 M adenosine diphosphate (ADP) or 1.7 g/mL collagen using a light transmittance aggregometer in the Japanese general population without medication or cardiovascular disease (387 men and 550 women) in the Suita Study.

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Platelet tests in the prediction of myocardial infarction and ischaemic stroke: evidence from the Caerphilly Prospective Study

Cited by 38 publications

References 33 publications

Mediterranean diet, but not red wine, is associated with beneficial changes in primary haemostasis

Mediterranean diet, but not red wine, is associated with beneficial changes in primary haemostasis

Milk drinking, ischaemic heart disease and ischaemic stroke I. Evidence from the Caerphilly cohort

Association of Platelet Aggregation with Lipid Levels in the Japanese Population: the Suita Study

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