Platelet and fibrinogen survival in coronary atherosclerosis. Response to medical and surgical therapy.

Survival times of chromium-51 platelets and iodine-125 fibrinogen were determined in 58 men with documented coronary atherosclerosis. Compared with findings in a control group of 28 men of similar age, mean platelet survival time was selectively shortened (6.8 +/- 1.8 [standard deviation] days versus 9.0 +/- 1.0 days; P less than 0.0001) without a decrease in fibrinogen survival time. More than half of the patients (31 of 58) had a platelet survival time of less than 7.0 days (2 standard deviations from the mean survival time in control subjects). Mean platelet survival time improved toward normal in nine patients after coronary revascularization (preoperative 5.1 +/- 0.9 days, postoperative 7.1 +/- 1.5 days; P less 0.001) and in 13 patients after administration of dipyridamole and acetylsalicylate (4.8 +/- 0.5 days versus 7.0 +/- 0.8 days; P less than 0.001). We conclude that selective platelet consumption occurs in atherosclerotic coronary vessels of some patients and that medical or surgical intervention may inhibit this process.