Shortened bleeding time in acute myocardial infarction and its relation to platelet mass.

doi:10.1136/bmj.290.6484.1767

Br Med J (Clin Res Ed) 1985;290:1767-1770 (15 June), doi:10.1136/bmj.290.6484.1767

Shortened bleeding time in acute myocardial infarction and its relation to platelet mass.

P C Milner, J F Martin

The bleeding time, using the Simplate method, horizontal incision,and venostasis, was measured in a study of 51 patients admittedto a coronary care unit within 12 hours of the onset of chestpain. The bleeding time was significantly shorter in the 28patients who were found to have definite myocardial infarctioncompared with the 23 others with chest pain but no definiteinfarction (p less than 0.0005). A bleeding time of less than212 seconds correctly classified 84% of patients (sensitivityfor definite myocardial infarction 89%) presenting to the coronarycare unit with chest pain. Multiple regression analysis showedthe bleeding time in all patients to be determined independently(and with high significance) by the following variables in orderof importance: diagnostic group, platelet mass (platelet countX mean volume), and age. Packed cell volume was not a significantdeterminant. In the group with definite myocardial infarctionconsidered alone the same order of variables was observed inpredicting bleeding time, but none of them was significant.A major variable reducing bleeding time in acute myocardialinfarction remains to be determined. There was no associationbetween bleeding time and creatine phosphokinase activity orinfarct size in the group with definite myocardial infarction.

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