Document Detail

Platelet reactivity in response to mental stress in syndrome X and in stable or unstable coronary artery disease.
MedLine Citation:
PMID:  15850605     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Previous studies showed differences in platelet reactivity in response to exercise in patients with syndrome X (SX) and those with obstructive coronary artery disease (CAD). In this study, we investigated whether similar differences could be detectable in response to a mental stressful stimulus. MATERIALS AND METHODS: We studied 30 SX patients (60+/-8 years, 8 men), 20 patients with stable angina and angiographically documented CAD (SA, 66+/-8 years, 14 men), and 11 patients with unstable angina (UA, 67+/-8 years, 6 men). A control group of 22 healthy controls (50+/-7 years, 5 men) was also studied. All subjects underwent a mathematical mental stress test (MST) consisting of rapid consecutive subtractions of number 7 for a period of 5 min. A venous blood sample was collected at baseline and immediately after MST. Platelet reactivity was measured on flowing blood as time necessary to occlude a ring coated with collagen-adenosine diphosphate (ADP; closure time, CT), using the platelet function analyzer (PFA-100) system. RESULTS: At rest, CT was lower in UA patients (87+/-19 s) compared to controls (109+/-24 s, p=0.02) and SA patients (105+/-37 s, p=0.055), and also tended to be lower in SX patients (96+/-18 s) compared to controls (p=0.07). The CT response to MST differed significantly among groups (p=0.0009). At peak MST, CT did not change in controls (110+/-27 s, p=0.88), whereas it decreased in SA patients (96+/-29 s, p=0.003) and tended to decrease in UA patients (82+/-15 s, p=0.25). In contrast, a significant increase in CT with MST was shown in SX patients (103+/-21 s, p=0.007). CONCLUSIONS: Platelet reactivity is increased by MST in patients with CAD, whereas it paradoxically decreases in SX patients, which may constitute a protective effect against stress-induced events in these patients.
Alfonso Sestito; Antonella Maccallini; Gregory Angelo Sgueglia; Fabio Infusino; Claudio Larosa; Cristina Aurigemma; Filippo Crea; Gaetano Antonio Lanza
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Publication Detail:
Type:  Journal Article     Date:  2004-11-06
Journal Detail:
Title:  Thrombosis research     Volume:  116     ISSN:  0049-3848     ISO Abbreviation:  Thromb. Res.     Publication Date:  2005  
Date Detail:
Created Date:  2005-04-26     Completed Date:  2005-10-07     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  25-31     Citation Subset:  IM    
Istituto di Cardiologia, Università Cattolica del S. Cuore, L.go A. Gemelli, 8 00168-Roma, Italy.
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MeSH Terms
Angina Pectoris / blood,  psychology
Coronary Artery Disease / blood,  psychology*
Microvascular Angina / blood,  psychology*
Middle Aged
Platelet Activation*
Platelet Function Tests
Stress, Psychological / blood*
Comment In:
Thromb Res. 2006;117(3):351-2   [PMID:  16084573 ]

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