Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/9936
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dc.contributor.authorChirkov, Y.en
dc.contributor.authorHolmes, A.en
dc.contributor.authorWilloughby, S.en
dc.contributor.authorStewart, S.en
dc.contributor.authorWuttke, R.en
dc.contributor.authorSage, P.en
dc.contributor.authorHorowitz, J.en
dc.date.issued2001en
dc.identifier.citationJournal of the American College of Cardiology, 2001; 37(7):1851-1857en
dc.identifier.issn0735-1097en
dc.identifier.issn1558-3597en
dc.identifier.urihttp://hdl.handle.net/2440/9936-
dc.descriptionCopyright © 2001 American College of Cardiology. Published by Elsevier Science Inc.en
dc.description.abstractOBJECTIVES The study examined possible clinical determinants of platelet resistance to nitric oxide (NO) donors in patients with stable angina pectoris (SAP) and acute coronary syndromes (ACS), relative to nonischemic patients and normal subjects. BACKGROUND We have shown previously that platelets from patients with SAP are resistant to the antiaggregating effects of nitroglycerin (NTG) and sodium nitroprusside (SNP). METHODS Extent of adenosine diphosphate (1 μmol/liter)-induced platelet aggregation (impedance aggregometry in whole blood) and inhibition of aggregation by NTG (100 μmol/liter) and SNP (10 μmol/liter) were compared in normal subjects (n = 43), nonischemic patients (those with chest pain but no fixed coronary disease, (n = 35) and patients with SAP (n = 82) or ACS (n = 153). Association of NO resistance with coronary risk factors, coronary artery disease (CAD), intensity of angina and current medication was examined by univariate and multivariate analyses. RESULTS In patients with SAP and ACS as distinct from nonischemic patients and normal subjects, platelet aggregability was increased (both p < 0.01), and inhibition of aggregation by NTG and SNP was decreased (both p < 0.01). Multivariate analysis revealed that NO resistance occurred significantly more frequently with ACS than with SAP (odds ratio [OR] 2.3:1), and was less common among patients treated with perhexiline (OR 0.3:1) or statins (OR 0.45:1). Therapy with other antianginal drugs, extent of CAD, intensity of angina and coronary risk factors were not associated with variability in platelet responsiveness to NO donor. CONCLUSIONS Patients with symptomatic ischemic heart disease, especially ACS, exhibit increased platelet aggregability and decreased platelet responsiveness to the antiaggregatory effects of NO donors. The extent of NO resistance in platelets is not correlated with coronary risk factors. Pharmacotherapy with perhexiline and/or statins may improve platelet responsiveness to NO.en
dc.description.statementofresponsibilityYuliy Y. Chirkov, Andrew S. Holmes, Scott R. Willoughby, Simon Stewart, Ronald D. Wuttke, Peter R. Sage and John D. Horowitzen
dc.language.isoenen
dc.publisherElsevier Science Incen
dc.subjectBlood Platelets; Humans; Coronary Disease; Angina Pectoris; Syndrome; Acute Disease; Nitroprusside; Nitric Oxide; Nitroglycerin; Multivariate Analysis; Platelet Aggregation; Adult; Aged; Middle Aged; Female; Maleen
dc.titleStable angina and acute coronary syndromes are associated with nitric oxide resistance in plateletsen
dc.typeJournal articleen
dc.identifier.rmid0020011120en
dc.identifier.doi10.1016/S0735-1097(01)01238-4en
dc.identifier.pubid61560-
pubs.library.collectionMedicine publicationsen
pubs.verification-statusVerifieden
pubs.publication-statusPublisheden
dc.identifier.orcidStewart, S. [0000-0001-9032-8998]en
dc.identifier.orcidHorowitz, J. [0000-0001-6883-0703]en
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