Platelet Aggregation in Whole Blood Is a Paradoxical Predictor of Ischaemic Stroke: Caerphilly Prospective Study Revisited

Details

• Personal Author:
  Andrew, Michael E. ; Ben-Shlomo Y ; Beswick AD ; Elwood PC ; Sharp DS
• Description:
  The Caerphilly Prospective Study demonstrates a paradoxical association of increased ischaemic stroke risk with decreased whole blood adenosine diphosphate (ADP) induced platelet sensitivity. A reanalysis of this association examines whether other haematological indices and prevalent disease at baseline may explain this finding. There were 1506 men free of clinical cardiovascular disease at baseline, with 85 men manifesting a first ischaemic stroke event over 8.3 years of follow-up in this population-based prospective cohort study. Using two different approaches, the paradoxical findings are confirmed and associations are slightly stronger after accounting for red cell, platelet, and white cell indices. A U-shaped relation of stroke with platelet count is noted. These findings are consistent with the existence of sub-clinical endothelial disease and compensatory mechanisms down-regulating ADP-induced aggregation sensitivity. They support an allostasis model of causality for understanding the paradox. A public health approach to prevention could have measurable impact if intervention strategies can be developed to alter early stages of disease appropriate to such mechanisms of causation. [Description provided by NIOSH]
• Subjects:
  Cardiovascular Diseases Cardiovascular System Epidemiology Hazardous Substances Hematologic Tests Occupational Health Public Health Risk Assessment Risk Factors Safety
• Keywords:
  Blood-analysis Cardiovascular-disease Cardiovascular-system-disease Cardiovascular-system-disorders Health-hazards Platelets Public-health Red-blood-cells Risk-analysis Risk-factors
• ISSN:
  0953-7104
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; West Virginia
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  HELD - Health Effects Laboratory Division
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  320-328
• Volume:
  16
• Issue:
  6
• NIOSHTIC Number:
  nn:20028771
• Citation:
  Platelets 2005 Sep; 16(6):320-328
• Email:
  dsharp@cdc.gov
• Federal Fiscal Year:
  2005
• Peer Reviewed:
  True
• Source Full Name:
  Platelets
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:19c3664ac205de31a93c96400a4222c76a18ceb5c08b35ad5d6113e960c511e27e559fb203ce21f4fe5f9af0136a690f82fd93907ebecb5cdcdd468ab52fd216
• Download URL:
  https://stacks.cdc.gov/view/cdc/189909/cdc_189909_DS1.pdf
• File Type:
  [PDF - 287.75 KB ]