Platelet Survival in Patients with Rheumatic Heart Disease

Abstract
Platelet studies were carried out in patients with valvular heart disease to determine the correlation of results with thromboembolism. Platelet survival was normal in 11 patients with aortic stenosis, and no thromboembolism occurred. In 55 patients with mitral stenosis, average platelet survival was slightly shortened. In 29, thromboembolism had occurred, and mean platelet survival was abnormal and significantly shorter than in the 26 patients without thromboembolism. Of patients with thromboembolism, 93 per cent had short survival as compared to 31 per cent of those without thromboembolism. Thromboembolism had occurred in 83 per cent of patients with short platelet survival as compared to 10 per cent in those with normal platelet survival. The results demonstrate that short platelet survival differentiates patients with mitral-valve disease and a history of thromboembolism from those without thromboembolism. Such studies done prospectively may identify thromboembolism-prone patients in whom platelet-inhibitor therapy may prove useful. (N Engl J Med 290:537–539, 1974)