INCREASED PLATELET AND COAGULATORY ACTIVITY IN PERIPHERAL ATHEROSCLEROSIS FLOW-MEDIATED PLATELET-FUNCTION IS A SENSITIVE AND SPECIFIC DISEASE INDICATOR

The importance of now in both athero- and thrombogenesis is well estab lished. In peripheral arterial disease (PAD) atherosclerosis is dissem inated, thrombosis risk high and systemic hemostatic derangement belie ved contributory. We studied platelet and coagulatory activity in PAD patients, thereby evaluating the clinical efficacy of Stagnation Point Flow Adhesio-Aggregometry (SPAA). SPAA provides real-time quantitativ e assessment of platelet adhesion and aggregation under convective, lo w-shear flow conditions. 62 nondiabetic PAD patients and 66 healthy vo lunteers were examined, whereby SPAA and conventional aggregometry wer e performed and circulating fibrinogen, fibrin monomer (FM), the fibri n degradation product D-Dimer and thrombin-antithrombin-complex (TAT) assessed. Conventional aggregometry detected no differences between pa tients and controls. SPAA-measured platelet function (p<0.001), fibrin ogen (p<0.001), FM (p<0.001), TAT (p<0.02) and D-Dimer (p<0.001) were significantly increased in patients and not effected by aspirin therap y. Respective sensitivity and specificity in detecting PAD was as foll ows: SPAA (96%/95%), fibrinogen (36%/92%), FM (46%/88%), TAT (40%/73%) , D-Dimer (75%/80%). Increased platelet and coagulatory activity was V erified in PAD, whereby flow-mediated platelet adhesion and aggregatio n proved the most sensitive and specific parameter. These findings ind icate the usefulness of SPAA for delineating platelet-related disease mechanisms and evaluating therapeutic strategies to prevent platelet a ctivation.