To the Editor: The paper by Pantely et al. demonstrated that when antiplatelet therapy was instituted three days after coronary-artery bypass, there was no improvement in graft patency.1 Platelet adhesion and release of platelet products into the vessel wall are presumably related to vascular myointimal proliferation and release of a platelet-derived mitogen that stimulates smooth-muscle cells to proliferate.2 Experimental studies have confirmed this hypothesis by showing that myointimal proliferation after endothelial injury can be prevented by rendering animals thrombocytopenic before the injury.3 However, platelet granules are released almost immediately after endothelial injury, as shown in several studies of platelet turnover. . No extract is available for articles shorter than 400 words.
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