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European Heart Journal 1995 16(1):1800-1806;
Copyright © 1995 by the European Society of Cardiology.
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© 1995 The European Society of Cardiology

Platelet and leukocyte activation after myocardial infarction

Influence of enalapril

C. SYLVÉN, I. HAGERMAN, K.-E. KARLBERG, J. CHEN, R. WALLIN, P. ENEROTH, K. BERGSTRÖM and T. SALDEEN

Karolinska Institute, Departments of Medicine, Clinical Chemistry, Biochemistry and Clinical Physiology, Huddinge University Hospital Stockholm Department of Forensic Medicine, University of Uppsala Uppsala, Sweden

revised 2 March 1995; accepted 4 April 1995.

Correspondence: Christer Sylvén, MD, PhD, FESC, Department of Medicine, Huddinge University Hospital, S-141 86 Huddinge, Sweden

Abstract

In this double-blind placebo-controlled study with enalapril, 74 patients with acute myocardial infarction were followed at 0, 7, 30, 60 and 180 days after the event. Platelets and leukocytes were activated during the first 7 days. During the 6-month period fibrinogen, leukocytes, elastase, and Bß 30–43 remained elevated in 50, 15, 30 and 80% of the patients, respectively, but there was no detectable angiotensin converting enzyme activity in platelets. Enalapril did not modulate fibrinogen, leukocyte count or elastase, while Bß 30–43 peptide showed decreased levels, although the proportion of patients with values above the reference limit did not differ from placebo. In conclusion, in the 6-month post acute myocardial infarction period, while platelet function is activated only during the first week after acute myocardial infarction, fibrinogen and leukocyte function continue to be activated throughout the 6 months in a considerable proportion of patients. These signs may indicate an ongoing atherosclerotic process. Enalapril has no major influence on these reactivities.

Key Words: Acute myocardial infarction • convalescence • platelets • leukocytes • fibrinogen • enalapril


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