Author + information
- Paul A. Gurbel,
- Kevin Bliden,
- Christopher McLeod,
- Tushar Sharma,
- Rahul Chaudhary and
- Udaya Tantry
Background: Circadian fluctuations in hemostatic factors are implicated in thrombotic event occurrences in the morning hours. No studies have serially assessed thrombogenicity and hemodynamics in the controlled environment.
Methods: Hemodynamics and blood samples were serially collected in aspirin-treated patients with type 2 diabetes and multiple cardiovascular risk factors (n=32). Measurements were performed at 7-9AM, 7-9PM, 11PM-1AM, and at 5-7AM (awakening). Clotting time (R, min) and thrombin induced platelet-fibrin clot strength (TIP-FCS, mm) were assessed by thrombelastography, and ADP-, AA- and collagen-induced platelet aggregation by conventional aggregometry, and Multiplate analyzer. BP and blood samples were obtained after 10 mins in the supine position in the same arm.
Results: Clotting time was markedly shorter in the morning as compared to the evening and just awaking hours (p< 0.05; Figure). Pulse pressure was higher during waking hours (p<0.05). There were no changes in platelet reactivity by any agonists between time points.
Conclusions: Heightened thrombin generation/response to thrombin occurs in the awakening hours and is unrelated to changes in platelet reactivity. The latter finding suggests that anticoagulant therapy may play a greater role in modification of early morning thrombotic event occurrence in high risk patients. Studies of personalized anticoagulant therapy in high risk patients with heightened thrombin generation/response to thrombin are warranted.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Biomarkers and Targets for Ischemic Heart Disease
Abstract Category: 1. Acute and Stable Ischemic Heart Disease: Basic
Presentation Number: 1164-301
- 2017 American College of Cardiology Foundation