Sticky Platelet Syndrome
Here is a message sent last week by Prof. Bernadette (Bunny) Rodak, chief editor of Hematology; Clinical Principles and Applications, Elsevier, Inc, and of Clinical Laboratory Science, the journal of the American Society for Clinical Laboratory Science. This is from her niece, Susan O'Neill, The Baltimore Life Companies, Owings Mills, MD.
Hi Bunny,
My father-in-law was recently diagnosed with sticky platelet syndrome. He has been taking aspirin for 30 years and Plavix for the past year, and he is now starting on Coumadin. He has a history of two TIAs and one stroke and he has a hole in his heart. All of which, I think, have something to do with the platelets. When I look it up online, I can't understand what the heck it means. Can you put it in laymen's terms for me? Thanks, Susie
Hi, Bunny and Susie,
I'll begin by linking this post to a recent post entitled "platelet hyperaggregability" that reviews sticky platelet syndrome in detail. Platelet hyperaggrability may become the more prevalent term, replacing sticky platelet syndrome, although the latter seems more descriptive. You'll see that Mammen and Frenkel did ground-breaking work describing the condition and linking it to a number of thrombotic (blood-clotting) conditions. The more recent work by P. Bray and his colleagues lends independent authenticity, particularly as it identifies healthy individuals whose platelets are consistently hyperaggregable. In additionto the references given in the platelet hyperaggrebility post, Bray has a new article, Nambi V, Kimball KT, Bray PF, et al. Differences in responses of platelets to fluid shear stress in patients with peripheral artery disease (PAD) and coronary artery disease (CAD). Platelets 2009; 20:199-205.
Mammen and Frenkel showed that aspirin usually resolves platelet hyperaggregability, but they may not have been aware of the phenomenon called "aspirin resistance," a condition described in 15-20% of people taking aspirin who appear to gain no protective effect. If Susie's father-in-law has continued to have clotting episodes such as strokes or transient ischemic attacks (TIAs) in spite of aspirin therapy, it may help to test for aspirin resistance. For information, take a look at the AspirinWorks web site, which provides an aspirin resistance assay. Likewise, Accumetrics provides aspirin resistance and Plavix resistance methods.
By the way, your father-in-law, like many taking Coumadin, may soon grow weary of the need for monthly prothrombin time/INR (protime, PT/INR) tests. Tell him there may soon be an oral anticoagulant that requires no laboratory monitoring. At least two such drugs are currently before the FDA. Geo.
