Blood platelet count and function are related to total and cardiovascular death in apparently healthy men.

TLDR

Experimental animal and clinical studies show platelets play a key role in atherosclerosis and thrombus formation, yet prospective evidence linking platelet count or function to cardiovascular mortality was lacking before this study. The study aimed to evaluate whether platelet count and aggregation predict coronary heart disease risk in healthy middle‑aged men. Platelet counts and aggregation responses were measured in 487 healthy men during 1973–1975, with a subsample of 150 men undergoing ADP‑induced aggregation testing. Over 13.5 years, men in the top quartile of platelet count and the fastest ADP‑induced aggregation had significantly higher coronary heart disease mortality, a relationship not explained by traditional risk factors, providing the first prospective evidence linking platelet concentration and aggregability to fatal coronary heart disease.

Abstract

Experimental animal and clinical studies indicate that blood platelets have an important role in atherosclerosis and formation of thrombi. Prospective studies presenting evidence of an association between blood platelet count and cardiovascular mortality have not been performed.From 1973 to 1975, blood platelets were counted, and their responsiveness to aggregating agents was studied in healthy middle-aged men. The aim was to assess the possible association between these variables and coronary heart disease. At 13.5 years of follow up, a significantly higher coronary heart disease mortality was observed among the 25% of subjects with the highest platelet counts. Platelet aggregation performed in a random subsample (150 of the 487 men), moreover, revealed that the 50% with the most rapid aggregation response after ADP stimulation had significantly increased coronary heart disease mortality compared with the others. These associations could not be explained by differences in age, lipids, blood pressure, or smoking habits.The present study is the first to present conclusive, prospective evidence of an association between platelet concentration and aggregability and long-term incidence of fatal coronary heart disease in a population of apparently healthy middle-aged men.