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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1999;19:672-679.)
© 1999 American Heart Association, Inc.

Original Contributions

A Role for Changes in Platelet Production in the Cause of Acute Coronary Syndromes

Bernd van der Loo; John F. Martin

From University College London, London W1P 9LN, United Kingdom.

Correspondence to Prof John Martin, University College London, 140, Tottenham Court Road, London W1P 9LN, United Kingdom. E-mail john.martin{at}ucl.ac.uk

Abstract—Platelets are heterogeneous with respect to their size, density, and reactivity. Large platelets are more active hemostatically, and platelet volume has been found to be increased both in patients with unstable angina and with myocardial infarction. Furthermore, platelet volume is a predictor of a further ischemic event and death when measured after myocardial infarction. Platelets which are anucleate cells with no DNA are derived from their precursor, the megakaryocyte. Therefore, it is suggested that changes in platelet size are determined at thrombopoiesis in the megakaryocyte and that those changes might precede acute cardiac events. Understanding of the signaling system that controls platelet production may also further elucidate the cascade of events leading to acute vascular occlusion in some patients.

Key Words: platelets • myocardial infarction • unstable angina • coronary heart disease • thrombosis

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