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European Heart Journal 1990 11(9):819-823;
Copyright © 1990 by the European Society of Cardiology.
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© 1990 The European Society of Cardiology

Exercise-induced platelet aggregation in angina and its possible prevention by ß1-selective blockade

K. WlNTHER*, and E. REIN{dagger}

*Department of Clinical Chemistry, Hvidovre Hospital
{dagger}Department of Clinical Chemistry, Frederiksberg Hospital Copenhagen, Denmark

Received 24 April 1989; revised 27 November 1989; .

Correspondence Kaj Winther M. D., Department of Clinical Chemistry, Hvidovre Hospital, 2650 Hvidovre, Copenhagen, Denmark.

Abstract

Moderate exercise increased platelet aggregability of 12 middle-aged men with stable angina pectoris: the mean ADP threshold fell from 4.58±0.63 to 3.18±0.41µm, P<0.01. Exercise did not, however, alter platelet aggregability in 12 healthy matched controls.

Physical effort approximately doubled the plasma levels of adrenaline and noradrenaline in patients as well as in controls. Under the same conditions the cAMP content of platelets fell in the angina group from 20.86±1.86 to 17.78±1.71 pmol 10–9 platelets, P<0.01, while there was no change in control levels. The fall of cAMP could account for the observed increase in platelet aggregability.

We speculate that the increased aggregability of platelets in the exercising anginal subjects represents an imbalance between prostacyclin release and haemodynamic changes.

The ß1selective blocker metoprolol, in usual therapeutic dosages, prevented the observed platelet changes probably by minimizing the haemodynamic disturbances and stimulating release of prostacyclin.

Key Words: Exercise • platelet aggregation • cardiovascular disease • beta-adrenoceptor blockade


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