Venous Hypertension Induces Increased Platelet Reactivity and Accumulation in Patients with Chronic Venous Insufficiency

Abstract

The objective of this study was to determine whether there are changes in platelet activation and rheology in patients with chronic venous insufficiency (CVI) and what their impact is on this disease. Anticoagulated peripheral venous blood collected from 21 patients with CVI and 13 normal control subjects in different bodily positions was incubated either with 0.5 mumol/L adenosine diphosphate (ADP) or without agonist and analyzed by whole blood flow cytometry. Soluble P-selectin was analyzed in obtained sera by enzyme-linked immunosorbent assay. Platelet count was determined by a whole blood analyzer. Circulating platelets were more reactive to stimulation with 0.5 mumol/L ADP in patients with CVI compared with control subjects. There was no statistically significant change in platelet activation without ADP and the level of soluble P-selectin as a function of posture. Under simulated venous hypertension, platelet accumulation was observed in patients with CVI. Patients with CVI had increased platelet reactivity and accumulation during orthostasis, suggesting this might be a contributory factor to CVI pathogenesis.

Low dose aspirin as adjuvant treatment for venous leg ulceration: pragmatic, randomised, double blind, placebo controlled trial (Aspirin4VLU)

“…The haemodynamic forces associated with venous hypertension in venous leg ulcers activate leucocytes and cause platelet aggregation and activation. Patients with chronic venous insufficiency have statistically significantly higher platelet counts compared with normal controls or people with non-venous leg ulcers, 11 12 increased platelet reactivity compared with normal controls, 13 and increased levels of platelet microparticles (shed by activated platelets). 12 …”

Influence of Aspirin Therapy in the Ulcer Associated With Chronic Venous Insufficiency

“…11 In addition, several cytokines, free radicals, and proteolytic enzymes are synthesized and released by activated leukocytes to restructure the vessel wall but ultimately lead to the aggravation of venous disease. 12 A number of drugs capable of modifying leukocyte activation have been evaluated in patients with venous ulceration with different results. These include studies with pentoxifylline, prostaglandin E 1 , prostacyclin analogs, flavonoids, and ASA.…”

A systematic review of circulating markers in primary chronic venous insufficiency

“…Of the 17 studies identified, 14 were case-control studies, including a total of 622 cases and 644 controls, [15][16][17][18][19][20][21][22][23][24][25][26][27][28] and the remaining studies related the concentration of markers to the severity of venous disease in a total of 212 subjects (Table 1). [29][30][31] The total sample size of the studies identified varied considerably.…”