Plasma glycocalicin levels are not elevated in patients with a history of transient ischaemic event and are normal in aspirinated normal volunteers

Effects of asymptomatic abdominal aortic aneurysm on the soluble coagulation system, platelet count and platelet activation

OBJECTIVES

the aim of the study was to determine the effects of infrarenal asymptomatic abdominal aortic aneurysm (AAA) on platelet count and activation.

DESIGN

prospective clinical study in a University Department of Vascular Surgery.

PATIENTS

one hundred and five patients with AAA. Thirty-two control patients with symptomatic carotid artery stenoses.

METHODS

platelet count (PC), plasma glycocalicin levels, prothrombin ratio (PTR), activated partial thromboplastin time (APPT), fibrinogen and D-dimer were measured in 23 patients with AAA and 16 control patients with symptomatic carotid artery stenoses. PC alone was measured in a further 84 patients with AAA and 16 with carotid artery stenoses.

RESULTS

PC was below the normal range in 8/105 patients and mean PC (215x10(9)/l, S.D. 47.5) was significantly lower than that of a control population (242x10(9)/l, S.D. 16.8) and patients with carotid disease (269x10(9)/l, S.D. 57). Glycocalicin level was above the normal range in 7/23 patients and the median level (28 fg/plt) was significantly higher than that of a normal population (21.6 fg/plt) and patients with carotid disease (12.3 fg/plt). Fibrinogen levels, PTR and APPT were all within the normal range. One patient had a minimally elevated level of D-dimer.

CONCLUSIONS

the combination of low PC and high glycocalicin levels suggests that there is increased platelet destruction, most likely due to activation within the aneurysm sac.