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Platelet tests in the prediction of myocardial infarction and ischaemic stroke: evidence from the Caerphilly Prospective Study
Author(s) -
Elwood P. C.,
Beswick A.,
Pickering Janet,
McCarron P.,
O'Brien J. R.,
Renaud S. R.,
Flower R. J.
Publication year - 2001
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1046/j.1365-2141.2001.02728.x
Subject(s) - medicine , stroke (engine) , myocardial infarction , platelet , cardiology , prospective cohort study , confidence interval , odds ratio , whole blood , cohort , mechanical engineering , engineering
A platelet test that is predictive of myocardial infarction (MI) and/or stroke would enable the targeting of anti‐platelet drugs towards high‐risk patients. The predictive power of several platelet tests for MI and for stroke was examined in 2000 older men in the Caerphilly Cohort Study of Heart Disease, Stroke and Cognitive Decline. The tests were: aggregation to adenosine diphosphate (ADP) in platelet‐rich plasma (PRP); aggregation to ADP in whole blood measured using an impedance method and a test of platelet aggregation induced in whole blood by high‐shear flow. Around 200 MIs and 100 ischaemic strokes occurred during a 10‐year follow‐up. Neither primary nor secondary aggregation in PRP was predictive of MI. However, the fifth of men in whom the primary response to ADP was least, showed the highest risk of a subsequent stroke [relative odds (RO) 1·64; 95% confidence interval (CI) 1·12–2·43]. Aggregation in whole blood was not predictive of MI but, again, the fifth of men with the least platelet response showed the highest stroke incidence (RO 1·79; 95% CI 1·06–3·00). Retention of platelets in the high‐shear test was not predictive of either event.