Circulation, Vol 71, 1129-1134, Copyright © 1985 by American Heart Association
SP Levine, BL Towell, AM Suarez, LK Knieriem, MM Harris and JN George
Platelets are believed to play a role in the pathogenesis of
atherosclerosis and of the vascular obstruction that causes the acute
complications of coronary artery disease. Since specific behavioral
patterns appear to be related to the development of coronary artery disease
and since emotional stress may predispose an individual to acute
cardiovascular ischemia, it was hypothesized that platelet activation by
catecholamines might be involved in these events. To study emotional
stress, plasma samples were obtained from 61 senior medical residents
immediately before they were to speak in public. There were significant
increases in the plasma concentrations of the platelet-secreted proteins
platelet factor 4 and beta-thromboglobulin and epinephrine and
norepinephrine immediately before speaking, which demonstrates that
platelet activation and secretion occur in association with this type of
emotional stress. Four trials were carried out to study the mechanism for
this observed platelet secretion: (1) phenoxybenzamine, (2) propranolol,
(3) 650 mg aspirin, and (4) 80 mg aspirin were given several hours before
the public speaking engagement. Neither phenoxybenzamine nor propranolol in
doses that blocked the hemodynamic effects of alpha 1- and beta
1-adrenergic stimulation modified platelet secretion. Aspirin also did not
block platelet secretion, which suggests that platelets were not being
stimulated through a cyclooxygenase-dependent pathway. This study provides
direct evidence of platelet secretion in vivo in association with emotional
stress, and underscores the potential importance of platelet activation and
secretion in the acute events that occur in patients with vascular disease.
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Platelet activation and secretion associated with emotional stress
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