Thrombosis pp 51-72 | Cite as

Platelet Aggregation: Relevance to Thrombotic Tendencies

  • M. A. Packham
  • J. F. Mustard
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 102)


Platelets change shape, aggregate, and release their granule contents in response to a number of agents that they may encounter in vivo. Some understanding has been gained concerning the mechanisms involved in these platelet reactions; released ADP, products formed from platelet arachidonic acid when platelet phospholipase A2 is activated, and at least one other mechanism contribute to aggregation responses. Many investigators have reported that platelets are more responsive to aggregating agents in vitro or aggregate spontaneously in some conditions associated with cardiovascular disease. Tests that are thought to detect circulating platelet aggregates have also been developed. However, the increased sensitivity demonstrated by all these tests may be a result of vascular disease rather than its cause.

Platelet hypersensitivity has also been noted in association with some dietary lipids, hyperbetalipoproteinemia, smoking, and stress. In many cases, the abnormal platelet responsiveness seems to be attributable to increased activation of the arachidonate pathway, possibly through increased sensitivity of phospholipase A2 in the platelet membrane. Evidence for this concept is that drugs such as aspirin which block the action of the cyclo-oxygenase of this pathway and thus prevent the formation of prostaglandin endoperoxides PGG2 and PGH2, and of thromboxane A2, abolish the platelet hypersensitivity that can be demonstrated by tests of biphasic aggregation responses to ADP or epinephrine. There is a large overlap, however, in the sensitivity of platelets from normal and abnormal groups, and it seems unlikely that platelet aggregation tests will prove to be of great value in assessing patients with thrombosis or in predicting the likelihood of the occurrence of the complications of atheroclerosis.

Other methods of detecting thrombosis include platelet survival measurements; determination of platelet coagulant activities; detection of materials (such as platelet factor 4 and β-thromboglobulin) released from platelets that have taken part in thrombus formation; and detection of such platelets on the basis of the reduction in platelet density that results from their exposure to thrombin and participation in reversible thrombus formation.


Platelet Aggregation Paroxysmal Nocturnal Hemoglobinuria Transient Cerebral Ischemia Thrombotic Tendency Platelet Aggregation Test 
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Copyright information

© Springer Science+Business Media New York 1978

Authors and Affiliations

  • M. A. Packham
    • 1
    • 2
  • J. F. Mustard
    • 1
    • 2
  1. 1.Department of BiochemistryUniversity of TorontoTorontoCanada
  2. 2.Department of PathologyMcMaster UniversityHamiltonCanada

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