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ACS and “Coronary Injury” is a “Platelet-Centric Disease”

Shear Stress, PCI

Plaque Rupture

ADP

TxA2

Granule Secretion

Membrane PL’s

Platelet Aggregation

Microaggregates

Myocardiall Infarction

GPIIb/IIIa Activation

X

X

X

Initial Activation

Sustained Activation

P-selectin CD-40L

PLT-WBC Aggregation/ Microparticles

Inflammation

Cytokine Release

Growth Factor Release

Restenosis

Stent Thrombosis

Procoagulant State

Hypercoagulability

Thrombin

TF

Aspirin

Clopidogrel

GP IIb/IIIa Inhibitor

TF

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