Elevated platelet reactivity in stable angina pectoris without significant coronary flow obstruction

J Cardiovasc Med (Hagerstown). 2008 Feb;9(2):129-30. doi: 10.2459/JCM.0b013e3280c56d46.


Background: There are many different causes of angina pectoris without significant coronary flow obstruction in major coronary arteries. Examples include Prinzmetal angina and small vessel atherosclerotic disease.

Methods: We investigated individuals with stable angina pectoris subject to elective coronary angiography. To keep the study group as homogeneous as possible, patients with diabetes mellitus were excluded. Subjects with normal coronary angiograms (n = 13) or insignificant (< 50%) coronary flow obstruction(s) (n = 4) were grouped together. The remaining cohort (n = 96) with at least one significant (> or = 50%) flow obstruction in at least one major coronary artery served as controls.

Results: Before angiography, platelet activity in vitro on stimulation with a thrombin-receptor activating peptide (TRAP-6) (57 micromol/l and 74 micromol/l) and ADP (1.7 micromol/l and 8.5 micromol/l) was determined. Angina pectoris individuals without significant flow obstruction in major coronary arteries had enhanced platelet reactivity both when stimulated with TRAP-6 and ADP (P < 0.01 for both TRAP-6 concentrations and P < 0.05 for both ADP concentrations, respectively.

Conclusions: It is concluded that angina pectoris without significant flow impediment in major epicardial arteries is associated with augmented platelet reactivity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenosine Diphosphate / pharmacology
  • Adult
  • Aged
  • Angina Pectoris / blood*
  • Angina Pectoris / physiopathology
  • Blood Platelets / drug effects*
  • Blood Platelets / physiology*
  • Coronary Circulation
  • Female
  • Flow Cytometry
  • Humans
  • Male
  • Middle Aged
  • Peptide Fragments / pharmacology
  • Platelet Activation
  • Receptors, Thrombin


  • Peptide Fragments
  • Receptors, Thrombin
  • thrombin receptor peptide (42-47)
  • Adenosine Diphosphate