Platelet HPA-1 a/HPA-1 b polymorphism and the risk of periprocedural myocardial infarction in patients undergoing elective PCI

Abstract

Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI) and large interests have been focused on platelets in order to prevent such a complication. The single nucleotide polymorphism Leu33Pro of platelet glycoprotein IIIa has been related to an increased platelet reactivity, a lower response to antiplatelet agents and higher risk of stent restenosis. Therefore, aim of our study was to evaluate the impact of this polymorphism on PMI in elective patients undergoing PCI. Our population is represented by 422 consecutive patients with cardiac biomarkers within normality undergoing elective PCI. We measured cardiac biomarkers (CK-MB and Troponin I) at baseline, and 8, 24 and 48 hours after the procedure. For all subjects, we performed genetic analysis to assess the presence of Leu33Pro polymorphism. A total of 136 patients (32.2%) were polymorphic. Those patients were younger (p = 0.03) and more often dislypidemic (p = 0.01). Angiographic features did not differ according to genetic status. Pharmacological treatment pre and during angioplasty was similar. PCI-related complications did not differ according to genotype, with the only exception of higher rate of distal embolization in polymorphic patients. However, Leu33Pro polymorphism was not associated with increased risk of periprocedural myonecrosis and PMI even after correction for baseline differences, (respectively OR = 1.22 [0.81-1.84], p = 0.34 for myonecrosis and OR = 1.66 [0.85-3.23]; p = 0.14 for PMI). At subgroup analysis, the Leu33Pro substitution was associated with higher risk of PMI only among diabetics (adjusted OR = 4.46 [1.12-17.76], p = 0.03). Among patients undergoing elective PCI, the polymorphism Leu33Pro of platelet glycoprotein IIIa is associated with increased risk of PMI only in diabetic patients.

The prognostic value of the platelet-to-lymphocyte ratio in acute coronary syndrome: a systematic review and meta-analysis

“…It has been shown that PLR was related to increased inflammatory activity and aggravated pro-thrombotic status due to megakaryocytic proliferation and relative thrombocytosis in high-risk patients with ACS [19][20][21]. Therefore, high platelet counts have been shown to reflect platelet activation and contribute to development of no-reflow via microvascular plugging, thrombus formation, and vasoconstriction [22,23]. In addition, lymphocytes have been shown to be a significant part of chronic inflammation in atherosclerotic process and to infiltrate the ischaemic and reperfused myocardium during ACS [24,25].…”

β3-integrin Leu33Pro gain of function variant does not modulate inflammatory activity in human derived macrophages in diabetes

“…Previous results suggested an association between the Leu33Pro variant in β3-integrin with macrovascular complications in diabetic patients 10 . Here, we did not find a significant difference in the prevalence of diabetic micro- and macrovascular complications associated with the Leu33Pro polymorphism.…”

Association of human platelet antigen polymorphisms with platelet count and mean platelet volume

“…Clinically, alloimmunization against HPA may result in three clinical conditions: neonatal alloimmune thrombocytopenia, post-transfusion purpura and platelet transfusion refractoriness [30]. Furthermore, previous studies have shown that HPA polymorphisms are associated with hepatitis C virus infection, progression of fibrosis in chronic hepatitis C, idiopathic thrombocytopenic purpura and periprocedural myocardial infarction [5,6,[31][32][33]. In the present study, we explored the correlation of HPA genotypes with the platelet count and MPV.…”