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• W2135202232 abstract "We read with interest the above-named article by Powell et al (J Vasc Surg 1999;30:844-53), which demonstrated an underlying state of platelet activation in patients with chronic venous insufficiency. As for systemic arterial circulation, it is known that platelet aggregability and adhesivity show a circadian pattern, with higher levels in the morning.1Tofler GH Brezinski D Schafer AI et al.Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden death.N Engl J Med. 1987; 316: 1514-1518Crossref PubMed Scopus (952) Google Scholar With a reduced endogenous fibrinolytic activity,2Andreotti F Davies GJ Hackett DR et al.Major circadian fluctuations in fibrinolytic factors and possible relevance to time of onset of myocardial infarction, sudden cardiac death and stroke.Am J Cardiol. 1988; 62: 635-637Abstract Full Text PDF PubMed Scopus (378) Google Scholar such morning trombophilic status may concur in determining the higher incidence of both cardiovascular3Cohen MC Rohtla KM Lavery CE Muller JE Mittleman MA Meta-analysis of the morning excess of acute myocardial infarction and sudden cardiac death.Am J Cardiol. 1997; 79: 1512-1516Abstract Full Text Full Text PDF PubMed Scopus (447) Google Scholar and cerebrovascular4Manfredini R Gallerani M Portaluppi F Salmi R Fersini C Chronobiological patterns of onset of acute cerebrovascular diseases.Thromb Res. 1997; 88: 451-463Abstract Full Text Full Text PDF PubMed Scopus (117) Google Scholar accidents. Moreover, peripheral acute arterial occlusion of the limbs is more likely to occur in the morning, too.5Manfredini R Gallerani M Portaluppi F Salmi R Zamboni P Fersini C Circadian variation in the onset of acute critical limb ischemia.Thromb Res. 1998; 92: 163-169Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar We do not know from Powell et al's results whether patients were measured for platelet-monocyte aggregates always at the same hour or not. It could be interesting, in fact, to verify whether a percentage of circulating aggregates could show any temporal differences (eg, comparing morning versus evening measurements in both healthy and venous chronic insufficient subjects). It is somewhat difficult to estimate, at the current level of knowledge, the possible physiopathological role (if any) of a circadian difference in platelet activation also in venous disease. On one hand, however, a circadian variation with a morning peak of occurrence has also been reported for pulmonary thromboembolism.6Manfredini R Gallerani M Portaluppi F Salmi R Chierici F Fersini C Chronobiological aspects of pulmonary thromboembolism.Int J Cardiol. 1995; 52: 31-37Abstract Full Text PDF PubMed Scopus (18) Google Scholar On the other hand, there could be a potential for therapeutic applications. It has been shown, in fact, that aspirin is more effective in reducing morning than evening myocardial infarctions,7Ridker PM Manson JE Buring JE Muller JE Hennekens CH Circadian variation of acute myocardial infarction and the effect of low-dose aspirin in a randomized trial of physicians.Circulation. 1990; 82: 897-902Crossref PubMed Scopus (265) Google Scholar and it also seems that thrombolysis efficacy may depend on the time of infarction.8Kurnik PB Circadian variation in the efficacy of tissue-type plasminogen activator.Circulation. 1995; 91: 1341-1346Crossref PubMed Scopus (108) Google Scholar A tailored therapeutic approach has been suggested for cardiovascular diseases,9Manfredini R Gallerani M Salmi R Fersini C Circadian rhythms and the heart: implications for chronotherapy of cardiovascular diseases.Clin Pharmacol Ther. 1994; 56: 244-247Crossref PubMed Scopus (32) Google Scholar and a deeper knowledge of temporal patterns of all underlying factors potentially leading to formation of thrombi could also be interesting in the venous bloodstream as well. 24/41/108647" @default.
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• W2135202232 title "Regarding “Chronic venous insufficiency is associated with increased platelet and monocyte activation and aggregation”" @default.
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