Platelet activation as a marker of heart attack

A key component of the pathology of myocardial infarction (i.e. heart attack) is platelet-rich thrombosis within the coronary arteries. In many cases this occurs despite the use of anti-platelet drugs such as aspirin, and this, alongside other evidence, prompts the search for novel markers of platelet activity, such as levels of platelet product soluble P selectin in the plasma. However, by themselves, high levels of soluble P-selectin are of insufficient sensitivity and specificity to contribute to the management of the chest pain that may be a heart attack. Conversely, the current report shows that low levels of soluble P selectin contribute to the diagnosis of myocardial infarction because, as low levels are so rarely found in this condition, heart attack can be ruled out. If confirmed, this will be a major step forward in the management of acute chest pain. (C) 2011 Elsevier B.V. All rights reserved.