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(Arteriosclerosis, Thrombosis, and Vascular Biology. 1995;15:748-753.)
© 1995 American Heart Association, Inc.

Articles

Whole-Blood Platelet Aggregation Predicts In Vitro and In Vivo Primary Hemostatic Function in the Elderly

Jonathan D. Emery; David W. Leifer; Glaci L. Moura; Patricia Southern; James H. Morrissey; Jeffry B. Lawrence

From the Institute of Pathology, Case Western Reserve University and University Hospitals of Cleveland, Cleveland, Ohio (J.D.E., D.W.L., G.L.M., P.S., J.B.L.), and the Oklahoma Medical Research Foundation, Oklahoma City (J.H.M.).

Abstract Increased platelet aggregation is associated with higher coronary artery disease mortality. Enhanced platelet aggregation in platelet-rich plasma has also been described in the elderly. To define age-related changes in primary hemostasis, we studied 37 elderly and 31 young blood donors. There were no significant age-related differences in whole-blood platelet aggregation, platelet adherence and thrombus formation on human umbilical artery segments, or bleeding time. Plasma fibrinogen was significantly higher in elderly men and women, whereas activated factor VII was elevated only in elderly women. Collagen-induced platelet aggregation was significantly correlated with platelet adherence to the subendothelium in elderly (r=.488, P=.002) but not in young donors. Accordingly, collagen-induced platelet aggregation showed a significant inverse correlation with bleeding time only in the elderly (r=-.401, P=.014). Arachidonic acid–induced platelet aggregation was significantly associated with platelet adherence to the subendothelium (r=.658, P=.003) and bleeding time (r=-.540, P=.021) only in elderly men. In young donors, ADP-induced platelet aggregation was significantly correlated with platelet adherence to the thrombogenic adventitial surface (r=.395, P=.031); in the elderly this association only approached significance (r=.315, P=.058). Whole-blood platelet aggregation in response to collagen and arachidonic acid may be more useful in predicting primary hemostatic function in the elderly than in the young. Furthermore, in the elderly, the correlation between platelet aggregation in whole blood and platelet–arterial wall interactions in vitro and in vivo may contribute to the ability of this test to predict coronary risk.

Key Words: platelet adherence • platelet aggregation • aging • fibrinogen • factor VII

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