Copyright © 1998 by the European Society of Cardiology.
Increased platelet activation and fibrinogen in Asian Indians. Potential implications for coronary risk
a Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
b Department of Medicine, Division of Cardiology, Johns Hopkins University, Baltimore, MD, U.S.A.
accepted September 19, 1997
Aims
To determine whether Asian Indians (Indians), a group known to have high rates of coronary heart disease, have increased platelet activation and fibrinogen levels relative to white Americans of European origin (whites).
Methods and Results
Forty healthy, non-smoking Indians, aged 25–45, were matched with 40 healthy whites for age (within 3 years) and gender. Platelet activation was tested in blood exiting a bleeding time wound at 1 and 2min post-incision (wound-induced activation), as well as in venous blood stimulated in vitro with collagen, using whole blood flow cytometry. Other risk factors, including fibrinogen levels, family history of diabetes or coronary heart disease, fasting insulin and lipid levels, and Lp(a) were also assessed. Fibrinogen levels were higher among Indians than whites, even after adjustment for gender or family history of coronary heart disease (P<0·05). Indians had higher levels of wound-induced glycoprotein IIb/IIIa binding and platelet secretion (P-selectin expression) than whites, with the greatest differences found when comparing the upper quintile of activation for each group (Ps<0·05). Indians with a family history of coronary heart disease (n=15) had higher levels of platelet secretion (wound-induced and in vitro) than Indians without a family history (Ps<0·05), while the relationship was reversed among whites. Platelet activation measures were not consistently related to other coronary risk factors, while fibrinogen was related to triglyceride and insulin levels among Indians.
Conclusion
Indians have elevated fibrinogen and platelet activation levels relative to whites. These factors may contribute to the increased coronary risk observed in Indians.
Key Words: India • platelet activation • fibrinogen • coronary disease
f1 Correspondence: Jerome Markovitz, MD, MPH, University of Alabama at Birmingham, 1717 Eleventh Avenue South room 733, Birmingham, AL 35205 U.S.A.
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