Intact endothelial cells are known to form a non-thrombogenic surface and to actively restrict the extent of thrombus formation on denuded vessel walls via such mechanisms as the binding of thrombin and activation of protein C, or the synthesis and release of prostacyclin. In an in vitro system, we have investigated how platelet inhibitors modulate the antithrombotic effects of human endothelial cells. Human endothelial cells isolated from umbilical veins were plated on one half of a subendothelial matrix (SEM) harvested from bovine cornea endothelial cells. The endothelial cells were preincubated with a drug and then exposed to anticoagulated whole blood from human donors in the presence or absence of the same drug and agitated for 15 min. The number and size of platelets interacting with the SEM were quantified by morphometric analysis.In our in vitro system, platelet aggregates on SEM that was partially covered with human endothelial cells were significantly smaller than on uncovered SEM. No difference in platelet adhesion was observed. In the absence of endothelial cells, the cyclooxigenase inhibitors acetylsalicylic acid (ASA) and flurbiprofen strongly reduced the size of aggregates formed on the SEM. Pretreatment of only the endothelial cells with ASA increased the size of the aggregates, while ASA treatment of endothelial cells as well as the whole blood did not reduce the mean aggregate size below that of controls. in contrast, the platelet phosphodiesterase inhibitors AHP 719 and UDCG 212 strongly decreased platelet aggregation without reducing platelet adhesion not only in the absence but also in the presence of endothelial cells pretreated with the inhibitors.Our results demonstrate that this in vitro model of a partially injured vessel wall is well suited to study the effects of endothelial cells on platelet function. Moreover, inhibitors of phosphodiesterase in contrast to ASA have profound antithrombotic effects in this model.