The role of exercise on platelet aggregation in patients with stable coronary artery disease: exercise induces aspirin resistant platelet activation.

Abstract:

OBJECTIVES:The aim of our study was to determine the relation between exercise stress test and aspirin resistance in patients with stable coronary artery disease. BACKGROUND:Clinically aspirin resistance is defined as having thrombotic and embolic cardiovascular events despite regular aspirin therapy. METHODS:We studied platelet functions of 62 patients with stable coronary artery disease and 20 subjects with normal coronary arteries by Platelet Function Analyzer (PFA-100, Dade Behring, Germany) at rest and after exertion with collagen and/or epinephrine (Col/Epi) and collagen and/or ADP cartridges. Closure time (CT)<186 seconds was defined as aspirin resistance with Col/Epi cartridges of PFA-100. Symptom limited treadmill stress test (protocol of Bruce) was performed with Oxford Streslink TD-1 system. RESULTS:8 (12.9%) patients were aspirin resistant by PFA-100 (CT<186s despite regular aspirin therapy) at rest. At the first minute of the recovery period of exercise stress test 14 (22.5%) patients were aspirin resistant by PFA-100. CTs with Col/ADP were respectively 89+/-6 s (83--100s) and 89+/-5 s (82--104s) at rest and after exercise (p=0.107). 20.3% (11/54) of patients known as in vitro aspirin sensitives at rest had shorter CTs and 11.1% (6/54) had aspirin resistance after exercise (p=0.004). There was no statistically significiant difference in platelet functions in the control group after exertion. CONCLUSION:We conclude that 11.1% of in vitro aspirin sensitive subjects at rest had aspirin resistance after exercise by PFA-100. In some individuals, exercise induced platelet activation is aspirin insensitive at usual antiplatelet doses. We need further clinical trials to optimize antiplatelet therapy in patients with coronary artery disease.

journal_name

J Thromb Thrombolysis

authors

Pamukcu B,Oflaz H,Acar RD,Umman S,Koylan N,Umman B,Nisanci Y

doi

10.1007/s11239-005-2318-1

subject

Has Abstract

pub_date

2005-08-01 00:00:00

pages

17-22

issue

1

eissn

0929-5305

issn

1573-742X

journal_volume

20

pub_type

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