Abstract
Moderate alcohol consumption (MAC) and platelet inhibition have been independently associated with a reduced risk for the development of acute myocardial infarction (AMI). The effects of MAC on the initial platelet status in patients presenting with AMI are not elucidated. Here we sought to define the effects of MAC on platelet characteristics in AMI patients before applying any reperfusion strategies. The study was designed as an analysis within the cohort study in 23 patients with AMI enrolled in the GUSTO-III. Platelets were investigated by different techniques, including aggregometry, flow cytometry, and ELISA. MAC patients exhibited mild, but consistent, inhibition of platelet aggregability, surface receptor expression, and released substances as compared to non-alcohol consuming patients. These differences were significant for 5 µM ADP (p = 0.04), 10 µM ADP-induced aggregation (p = 0.02); P-selectin (p = 0.01), and PECAM-1 (p = 0.02) platelet-bound expression. Our study confirms that moderate alcohol consumption is associated with diminished platelet activation in patients presenting with AMI. The ability of MAC to favorably modulate the pre-reperfusion platelet status in such patients is of clinical importance, and further investigation in large-scale clinical trials seem warranted.
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Marques-Vidal P, Ducimetierre P, Evans A, Cambou JP, Arveiler D. Alcohol consumption and myocardial infarction: a case-control study in France and Northern Ireland. Am J Epidemiol 1996;143:1089–1093.
Camargo CA, Jr., Stampfer MJ, Glynn RJ, et al. Moderate alcohol consumption and risk for angina pectoris or myocardial infarction in U.S. male physicians. Ann Intern Med 1997;126:372–375.
Becker RC. Thrombosis and the role of the platelet. Am J Cardiol 1999;83(9A):3E–6E.
Eccleston D, Topol EJ. Inhibitors of platelet IIb/IIIa as augmenters of thrombolysis. Cor Artery Dis 1995;6:947–955.
Torr SR, Winters KJ, Santoro SA, Sobel BE. The nature of interactions between tissue-type plasminogen activators and platelets. Thromb Res 1990;59:279–293.
Golino P, Ashton JH, Glas-Greenwalt P, McNatt J, Buja LM, Willerson JT. Mediation of reocculsion by thromboxane with tissue type plasminogen activator in a canine preparation of coronary thrombosis. Circulation 1988;77:678–684.
Gurbel PA, Serebruany VL, Shustov AR, et al. Effects of reteplase and alteplase on platelet aggregation and major receptor expression during the first 24 hours of acute myocardial infarction treatment. The GUSTO III Platelet Study. J Am Coll Cardiol 1998;31:1466–1473.
Roux SP, Tschopp TB, Kuhn H, Steiner B, Hadvary P. Effects of heparin, aspirin and synthetic platelet glycoprotein IIb/IIIA receptor antagonist on coronary artery reperfusion and reocculsion after thrombolysis with tissue-type plasminogen activator in the dog. J Pharm Exper Therap 1993; 264:501–508.
Kleiman NS, Ohman EM, Califf RM, et al. Profound inhibition of platelet aggregation with monoclonal antibody 7E3 Fab after thrombolytic therapy. Results of the Thrombolysis and Angioplasty in Mycardial Infarction (TAMI) 8 Pilot Study. J Am Coll Cardiol 1993;22:381–389.
Renaud SC, Ruf JC. Effects of alcohol on platelet functions. Clin Chem Acta 1996;246:77–89.
Rubin R, Rand ML. Alcohol and platelet function. Alcohol Clin Exper Res 1994;18:105–110.
Renaud SC, deLorgeril M. Wine, alcohol, platelets, and the French paradox for coronary heart disease. Lancet 1992; 339:1523–1526.
Pace-Asciak CR, Rounova O, Hahn SE, Diamandis EP, Goldberg DM. Wines and grape juices as modulators of platelet aggregation in healthy human subjects. Clin Chim Acta 1996;246:163–182.
The GUSTO Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med 1993;329:673–682.
Ruggeri ZM. New insights into the mechanisms of platelet adhesion and aggregation. Semin Hemat 1994;31:229–235.
Ault KA. Flow cytometric measurement of platelet function and reticulated platelets. Ann New York Acad Sci 1993; 677:293–308.
Serebruany VL, Gurbel PA, Shustov AR, et al. Depressed platelet status in a patient with hemorrhagic stroke following thrombolysis for acute myocardial infarction. Stroke 1998;29:235–238.
Gurbel PA, Navetta FI, Bates ER, et al. Lesion-directed administration of tissue plasminogen activator with intracoronary heparin in patients with unstable angina and coronary thrombus undergoing angioplasty. Cathet Cardiovasc Diagn 1996;37:382–391.
Jang IK, Gold HK, Ziskind AA, et al. Differential sensitivity of erythrocyte-rich and platelet-rich arterial thrombi to lysis with recombinant tissue-type plasminogen activator: A possible explanation for resistance to coronary thrombolysis. Circulation 1989;79:920–928.
Gold HK, Garabedian HD, Dinsmore RE, et al. Restoration of coronary flow in myocardial infarction by intravenous chimeric 7E3 antibody without exogenous plasminogen activators. Observations in animals and humans. Circulation 1997;95:1755–1759.
Mikhailidis DP, Barradas MA, Epemolu O, Dandona P. Ethanol ingestion inhibits human whole blood platelet impedance aggregation. Am J Clin Path 1987;88:342–345.
Veenstra J, van de Pol H, Schaafsma G. Moderate alcohol consumption and platelet aggregation in healthy middleagedmen. Alcohol 1990;7:547–549.
Pikaar NA, Wedel M, van der Beek EJ, et al. Effects of moderate alcohol consumption on platelet aggregation, fibrinolysis, and blood lipids. Metabol Clin Exper 1987;36:538–543.
Veenstra J, Kluft C, Ockhuizen TH, van de Pol H, Wedel M, Schaafsma G. Effects of moderate alcohol consumption on platelet function, tissue-type plasminogen activator and plasminogen activator inhibitor. Thromb Haemost 1990; 63:345–348.
Oda H, Suzuki M, Oniki T, Kishi Y, Numano F. Alcohol and coronary spasm. Angiology 1994;45:187–197.
Smith CM 2d, Tobin JD Jr, Burris SM, White JG. Alcohol consumption in the guinea pig is associated with reduced-megakaryocyte deformability and platelet size. J Lab Clin Med 1992;120:699–706.
Gorinstein S, Zemser M, Lichman I, et al. Moderate beer consumption and the blood coagulation in patients with coronary artery disease. J Intern Med 1997;241:47–51.
Seygneur M, Bonnet J, Dorian B, et al. Effect of the consumption of alcohol, white wine, and red wine on platelet function and serum lipids. J Appl Cardiol 1990;5:215–222.
Frankel EN, Kannor J, German JB, Parks E, Kansella JE. Inhibition of oxidation of human LDL by phenolyc substances and red wine. Lancet 1993;341:454–456.
Serebruany VL, Herzog WR, Atamas SP, et al. Hemostatic changes after dietary Coenzyme Q10 supplementation in swine. J Cardiovasc Pharm 1996;28:175–181.
Herzog WR, Schlossberg ML, Mortensen SA, Serebruany VL. Effect of coenzyme Q10 supplementation on platelet aggregability in swine. CoQ10 Res Biol Med 1995;3:5–8.
Serebruany VL, Ordonez JV, Herzog WR, et al. Dietary coenzyme Q10 supplementation alters platelet size and inhibits human vitronectin (CD51/CD61) receptor expression. J Cardiovasc Pharm 1997;29:16–22.
Demrow HS, Slane PR, Folts JD. Administration of wine and grape juice inhibits in vivo platelet activity and thrombosis in stenosed canine coronary arteries. Circulation 1995; 91:1182–1188.
Wannamethee G, Whincup PH, Shaper AG, Walker M, MacFarlane PW. Factors determining case fatality in myocardial infarction: “Who dies in a heart attack?” Br Heart J 1995;74:324–331.
Gaziano JM, Buring JE, Breslow JL, Goldhaber SZ, Rosner B, VanDenburgh M, Willett W, Hennekens CH. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829–1834.
Gaziano JM, Manson JE. Diet and heart disease. The role of fat, alcohol, and antioxidants. Cardiol Clin 1996;14:69–83.
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Serebruany, V.L., Lowry, D.R., Fuzailov, S.Y. et al. Moderate Alcohol Consumption is Associated with Decreased Platelet Activity in Patients Presenting with Acute Myocardial Infarction. J Thromb Thrombolysis 9, 229–234 (2000). https://doi.org/10.1023/A:1018762510842
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DOI: https://doi.org/10.1023/A:1018762510842