Division of Cardiology, Department of Medicine, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY 10016, USA.
J Thromb Thrombolysis. 2011 Aug;32(2):201-8. doi: 10.1007/s11239-011-0590-9.
Cardiovascular disease is a major cause of morbidity and mortality. Numerous risk scores exist to identify healthy individuals at increased risk of developing cardiovascular disease. Although platelets are a key mediator in the pathogenesis of cardiovascular disease, the role of platelet activity measurements and the incidence of cardiovascular disease are uncertain. Platelet aggregometry-the most well studied method of platelet function testing-is associated with risk factors for cardiovascular disease. However, data supporting platelet aggregation and incident cardiovascular disease is conflicting. Plasma markers of platelet activation are promising candidates. Soluble CD40L and P-selectin are easily measured with a standardized ELISA, and there is some data to suggest an association with cardiovascular disease, but further studies are required. While mean platelet volume is a promising candidate, platelet count and bleeding time are not specific for platelet activity nor are they associated with cardiovascular disease in a healthy population. For this field to progress, we recommend large-scale, prospective studies that measure a battery of these platelet function tests in individuals without cardiovascular disease to better understand the associations, if any, between platelet activity and cardiovascular disease.
心血管疾病是发病率和死亡率的主要原因。有许多风险评分系统可用于识别处于心血管疾病高风险的健康个体。虽然血小板是心血管疾病发病机制中的一个关键介质，但血小板活性测量和心血管疾病的发生率尚不确定。血小板聚集测定——血小板功能检测中研究最充分的方法——与心血管疾病的危险因素有关。然而，支持血小板聚集和心血管疾病发病的数据存在冲突。血小板激活的血浆标志物是很有前途的候选物。可溶性 CD40L 和 P-选择素可以通过标准化 ELISA 轻松测量，并且有一些数据表明与心血管疾病有关，但需要进一步的研究。虽然平均血小板体积是一个很有前途的候选物，但血小板计数和出血时间对于血小板活性并不特异，也与健康人群中的心血管疾病无关。为了推动这一领域的发展，我们建议进行大规模的前瞻性研究，在没有心血管疾病的个体中测量一系列这些血小板功能测试，以更好地了解血小板活性与心血管疾病之间的任何关联。
