Different interactions of platelets with arterial and venous coronary bypass vessels.

We studied the interaction of platelets with the wall of human internal mammary arteries and saphenous veins, suspended in organ chambers for measurement of isometric tension. Vessels were obtained during coronary bypass surgery and cut into 5 mm rings; in some the endothelium was chemically removed. Rings from several patients were randomly chosen for each experiment, and in each ring six concentrations of platelets (from healthy blood donors; 1-75 x 10(3)/microliters) were tested consecutively and concentration-response curves constructed; the areas under these curves were used for statistical comparisons. In rings of internal mammary artery contracted in response to noradrenaline, aggregating platelets induced endothelium-dependent relaxation which was prevented by apyrase (0.67 U/ml ADPase activity) and L-NG-monomethylarginine (1 mmol/l). By contrast, in saphenous vein rings contracted in response to noradrenaline, aggregating platelets induced only a further increase in tension. In quiescent vessels, the platelet-induced contraction did not occur in arteries with endothelium but that in veins was greater and facilitated by endothelium. Preincubation of platelets with aspirin (10 mumol/l) reduced the contraction in both vessels, but contraction was abolished only in the presence of both the thromboxane receptor antagonist SQ-30741 and the serotoninergic (5HT2) receptor antagonist ketanserin. These findings show that platelet-derived ADP causes release of nitric oxide by the endothelium of internal mammary artery but not of saphenous vein; thromboxane A2 and serotonin mediate contraction in vein but not artery with endothelium. These differences may contribute to differences in graft function and the clinical efficacy of antiplatelet drugs.

RCT Entities:   Population Interventions Outcomes