Clopidogrel Attenuates Coated-platelet Production in Patients Undergoing Elective Coronary Catheterization

Norgard, Nicholas B; Saya, Shoaib; Hann, C L; Hennebry, Thomas A.; Schechter, Eliot; Dale, George L.

doi:10.1097/fjc.0b013e3181907390

Cited by 30 publications

(26 citation statements)

References 12 publications

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“…Median follow-up duration among subjects who did not develop a recurrence and remained alive was not significantly different among the coated-platelet level groups (P ¼ 0.15). Table 2 summarizes the distribution of patient characteristics, including use of medications that may influence coated-platelet levels (SSRIs, statins, or antiplatelet medications), 1,7,8 at baseline according to coated-platelet tertile. There were no significant differences among the groups in terms of baseline characteristics.…”

Section: Resultsmentioning

confidence: 99%

“…Smoking status, 7 gender, race, age, National Institutes of Health Stroke Scale score, history of atrial fibrillation, hypertension, hypercholesterolemia, and large artery disease, and use of medications that may influence coated-platelet levels, such as SSRI (selective serotonin reuptake inhibitors), HMG-CoA reductase inhibitors (statins) or antiplatelet medications, 1,7,8 were recorded at the time of enrollment for each patient and reflected prehospitalization status and medication use. The use of medications that may influence coated-platelet levels (listed above), and additional treatments, such as anticoagulation or surgical/endovascular treatment for stroke prevention were recorded at the time of discharge.…”

Section: Materials and Methods Subjectsmentioning

confidence: 99%

“…1,7 Studies in humans and experimental animals have identified several modifiers of coated-platelet levels, including inflammation and some antiplatelet medications. [7][8][9] Previous studies in ischemic stroke indicated that mean coatedplatelet levels are elevated in patients with nonlacunar (largevessel) ischemic stroke compared with either controls without a history of stroke or patients with lacunar (small-vessel) ischemic stroke. 10 Furthermore, the presence of early hemorrhagic transformation in patients with nonlacunar ischemic stroke was associated with lower coated-platelet levels.…”

Section: Introductionmentioning

confidence: 99%

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Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

Prodan

Stoner

Cowan

et al. 2012

J Cereb Blood Flow Metab

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Coated-platelets are procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar (large-vessel) ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls. The purpose of this study was to investigate a possible relationship between coated-platelet levels and stroke recurrence in patients with nonlacunar ischemic stroke. We assayed coated-platelet levels in 190 consecutive patients with nonlacunar stroke who were followed for up to 12 months; 20 subjects experienced recurrent stroke. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time-to-recurrent stroke were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. The cumulative incidence of recurrent stroke at 12 months differed among the coated-platelet tertiles: 2% for the first tertile (lowest coated-platelet levels), 18% for the second tertile, and 17% for the third tertile (overall log-rank test, P ¼ 0.019). These data suggest that higher levels of coated-platelets, measured shortly after a nonlacunar stroke, are associated with an increased incidence of stroke recurrence. This observation offers an additional tool for identifying patients at highest risk for stroke recurrence following a nonlacunar (large-vessel) infarct.

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Section: Resultsmentioning

confidence: 99%

Section: Materials and Methods Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

Prodan

Stoner

Cowan

et al. 2012

J Cereb Blood Flow Metab

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“…Exclusion criteria consisted of (1) current use of anticoagulants, (2) any transfusion within 2 weeks before screening, and (3) history of dementia. 16 Smoking status, sex, race, age, and the use of medications that may influence coated-platelet levels, such as selective serotonin reuptake inhibitors, statins, or antiplatelet medications, 8,11,17 were recorded at the time of enrollment for each patient. Additional information recorded included a history of hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, peripheral arterial disease, or end-stage renal disease (ESRD).…”

Section: Study Populationmentioning

confidence: 99%

Coated-Platelets Improve Prediction of Stroke and Transient Ischemic Attack in Asymptomatic Internal Carotid Artery Stenosis

Kirkpatrick

Tafur

Vincent

et al. 2014

Stroke

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Also, patients with nonlacunar ischemic strokes who have higher levels of coated-platelets are more likely to have recurrent ischemic stroke than patients with lower coated-platelet levels, suggesting that coated-platelets may serve as a biomarker for stroke risk. 13 In addition, patients with symptomatic large-artery atherosclerosis and coated-platelet levels of ≥50% have a rate of early recurrent stroke 6-to 7-fold higher than those with coated-platelet levels of <50%.14 We soughtBackground and Purpose-Coated-platelets, a subset of procoagulant platelets observed on dual agonist stimulation with collagen and thrombin, support a robust prothrombinase activity and provide a unique measure of platelet thrombotic potential. Coated-platelet levels are increased in large artery stroke, and higher levels are associated with early stroke recurrence, suggesting a potential role for risk stratification in asymptomatic patients with carotid artery stenosis. Methods-Three-hundred twenty-nine consecutive patients with technically adequate carotid Doppler evaluation without stroke or transient ischemic attack (TIA) in the previous 6 months were enrolled as part of a prospective cohort study conducted during a 40-month period. The main outcome was occurrence of stroke or TIA according to coated-platelet levels and internal carotid stenosis severity at enrollment. The optimal cutoff value of coated-platelet levels was determined by recursive partitioning analysis. Event-free survival was estimated using Kaplan-Meier and Cox proportional hazards regression analyses. Results-A cutoff of ≥45% for coated-platelet levels in combination with stenosis ≥50% yielded a sensitivity of 0.78 (95% confidence interval, 0.51-1.0), specificity of 0.92 (0.89-0.95), positive predictive value of 0.21 (0.07-0.34), and a negative predictive value of 0.99 (0.98-1.0) for ipsilateral stroke or TIA. The incidence rate of ipsilateral stroke or TIA for patients with ≥50% stenosis and ≥45% coated-platelets was 21.5 per 100 person-years versus 1.27 per 100 person-years for patients with ≥50% stenosis and <45% coated-platelets (P<0.0001). Conclusions-Coated-platelet levels identify asymptomatic carotid stenosis patients at high risk for stroke or TIA, which suggests a role for coated-platelets in risk stratification before revascularization. (Stroke. 2014;45:2995-3001.)

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“…Exclusion criteria included current cigarette smoking or history of stroke, 15,16 traumatic brain injury, or acute coronary syndrome. We did not exclude individuals reporting use of medications that may influence coated-platelet levels, 17 such as selective serotonin reuptake inhibitors (SSRIs), HMG-CoA reductase inhibitors (statins), and antiplatelet agents, 17,18 at the time of enrollment because of the relatively high percentage of individuals in this age group taking one or more of these drugs. Instead, any potential modifying or confounding effects of these medications were explored statistically.…”

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confidence: 99%

Coated-platelet levels and progression from mild cognitive impairment to Alzheimer disease

Prodan¹,

Ross²,

Stoner³

et al. 2011

Neurology

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Objectives: Coated-platelets are a subset of platelets produced by dual-agonist activation with collagen and thrombin. These platelets retain full-length amyloid precursor protein on their surface, are elevated in patients with amnestic as compared to nonamnestic mild cognitive impairment (MCI), and correlate with disease progression in Alzheimer disease (AD). Prompted by these findings, we investigated the association between coated-platelet production in amnestic MCI and rate of progression to AD.Methods: Coated-platelet levels were assayed in 74 patients with amnestic MCI who were subsequently followed longitudinally for up to 36 months in an outpatient dementia clinic. Levels are reported as percent of cells converted into coated-platelets. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time to progression to AD were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. Cox proportional hazards regression was used to adjust for potential confounders.Results: The 24-month cumulative incidence of progression to AD was different among tertiles:4% for the first tertile (lowest coated-platelet levels), 13% for the second tertile, and 37% for the third tertile (overall log-rank test, p ϭ 0.02). The hazard rate of progression to AD for patients in the highest coated-platelet tertile was 5.1 times that for patients in the lowest tertile (p ϭ 0.04), whereas the hazard rate for the middle tertile was similar to that for the lowest tertile (hazard rate ratio ϭ 1.5, p ϭ 0.7). Conclusions:

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Clopidogrel Attenuates Coated-platelet Production in Patients Undergoing Elective Coronary Catheterization

Cited by 30 publications

References 12 publications

Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

Coated-Platelets Improve Prediction of Stroke and Transient Ischemic Attack in Asymptomatic Internal Carotid Artery Stenosis

Coated-platelet levels and progression from mild cognitive impairment to Alzheimer disease

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