The role of platelets in athero-thrombotic events.
The crucial role of platelets in primary hemostasis and repair of injured endothelium is well established, as is their role in atherothrombosis. No other single cell type is responsible for as much morbidity and mortality, since death from ischemic heart disease or stroke is by far the leading cause of death worldwide. There is no doubt that our understanding of atherothrombosis has guided current antithrombotic strategies that have dramatically reduced ischemic complications and cardiovascular mortality within the last decades. Yet the rate of ischemic complications after optimal revascularization therapy remains disappointingly high. There is still a strong need for new and smart antiplatelet drugs. The ideal antithrombotic drug would spare physiological platelet function, hemostasis and vascular repair in order to avoid bleeding complications, but would exclusively target the pathological atherothrombotic process. As platelet activity might be determined early in the bone marrow, this review starts with insights into the birth of platelets, describes the essential and primary role of platelets in hemostasis with new evidence in signaling cascades, and closes with the deleterious role of platelets in atherosclerosis and atherothrombosis, with a focus on acute coronary syndromes.
3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminen Hospital, A-1160, Vienna, Austria. matthias.freynhofer@meduniwien.ac.at
Matthias K
MK
Freynhofer
Veronika
V
Bruno
Johann
J
Wojta
Kurt
K
Huber
D000244:Adenosine Diphosphate / Q000097:blood; D000818:Animals; D050197:Atherosclerosis / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000097:blood; D003328:Coronary Thrombosis / Q000097:blood; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006487:Hemostasis / Q000187:drug effects; D006801:Humans; D058226:Plaque, Atherosclerotic; D015539:Platelet Activation / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013917:Thrombin / Q000378:metabolism; D013927:Thrombosis / Q000097:blood* / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D013928:Thromboxane A2 / Q000097:blood
D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D013928:Thromboxane A2; D000244:Adenosine Diphosphate; D013917:Thrombin