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We have shown (Lancet, 2, 995, 1976) that in normal men a diet substituting linoleic acid for most of the normal saturated fat intake is followed by marked changes in some of those platelet function tests which are abnormal in the prothrombotic state. Are these changes due to alterations in the plasma lipids?  Clofibrate (Atromid-S) and an analogue, ICI 55,897, were given in double blind cross over studies to respectively 10 and 19 patients with severe peripheral arterial disease and/or a past history of MI. Preliminary analysis indicates that in 3 weeks on 55,897 the mean heparin thrombin clotting time was normalized from 25 seconds pre-treatment to 30 seconds. The fibrinogen decreased from a mean of 371 to 332 mg/%, but this treatment had no effect on the anti-thrombic activity and no effect on the plasma lipids. In the Clofibrate study the lipids and the anti-thrombic activity decreased; the HTCT was probably ameliorated but a marked placebo effect confounded the statistical analysis. However, clinical records of patients to be presented strongly support these conclusions. Thus no simple single mechanism, e.g. a change in lipids, can account for the changes achieved. These observations, however, establish that these tests regularly found to be abnormal in groups of patients at risk of further thrombosis can be changed towards normal in patients by two ICI compounds. It is now vital to find out if these changes are beneficial to the patient.

Some Platelet Function Tests Normalized by ICI 55,897 and Clofibrate