Platelet membrane activation markers are predictive for increased risk of acute ischemic events after PTCA.

Abstract

BACKGROUND We wished to investigate whether platelet activation is related to the clinical outcome during the 24 hours immediately after elective percutaneous transluminal coronary angioplasty (PTCA). METHODS AND RESULTS In 102 patients with high-grade coronary stenosis admitted for elective PTCA, preprocedural platelet activation was characterized by flow cytometric measurement of the proteins CD62, CD63, and thrombospondin expressed on the platelet surface membrane. The prevalence of acute ischemic events during the 24 hours immediately after the procedure was then related to the pre-PTCA platelet activation status. Fifty-six patients were classified as "nonactivated," whereas 46 patients showed an increased percentage of activated platelets. Two patients developed acute occlusion (1.96%) and four patients high-grade restenosis (3.92%), as confirmed by second-look coronary angiography. All events occurred in patients classified as "activated" (six of 46, or 13%). None of these patients received beta-blocker medication, which was associated with lower expression of platelet membrane activation markers. In the nonactivated patient group, no clinical events were found (0 of 56, or 0%). This difference in prevalence is significant (p = 0.007). CONCLUSIONS We conclude that analysis of platelet membrane activation markers may help to predict an increased risk of acute ischemic events after angioplasty.

<b>Plasma Levels of IL-8 Predict Early Complications in Patients with Coronary Heart Disease after Percutaneous Coronary Intervention</b>

“…1,4,5,13,16,17) The results of this study extend our previous observations, demonstrating the predictive value of measuring plasma levels of IL-8 for early complications after coronary interventions. Buffon, et al reported that the preprocedural CRP level is a powerful predictor of both early and late outcome in patients undergoing single vessel PTCA.…”

“…11 ) The predictors of acute complications such as female gender, 12) advanced age, 13) lesion characteristics, 14) and haemostatic variables 15) have a poor practical value. 1,4,5,13,16,17) The results of this study extend our previous observations, demonstrating the predictive value of measuring plasma levels of IL-8 for early complications after coronary interventions.…”

Temporal changes in circulating P-selectin, plasminogen activator inhibitor-1, magnesium, and creatine kinase after percutaneous coronary intervention

“…It is known that coronary angioplasty induces platelet activation (Dehmer et al, 1997), and increased platelet activity is associated not only with ischemiareperfusion injury at the immediate stage, but also with restenosis at the late stage after coronary angioplasty (Tschoepe et al, 1993;Murasaki et al, 2007;Osmancik et al, 2008). In this study, we also found that the plasma P-selectin level at 5 min after PCI was positively correlated to inflation pressure, indicating that the increase in circulating P-selectin levels is partly due to vascular injury caused by coronary angioplasty.…”

“…Increased platelet activity, evidenced by membrane P-selectin expression on circulating platelets, is associated not only with a higher risk of stent thrombosis, but also with a higher risk of later restenosis development (Tschoepe et al, 1993;Murasaki et al, 2007;Osmancik et al, 2008). Plasminogen activator inhibitor-1 (PAI-1), an important member of the plasmin activation system, is a predictor of restenosis after stent placement (Katsaros et al, 2008).…”

Fluorine-Incorporated Amorphous Carbon Coating Inhibits Adhesion of Blood Cells to Biomaterials

“…In addition, CD62P expression is the platelet activation marker most closely associated with increased thrombotic risk. (22,23) P-selectin promotes fibrin deposition, inducing leukocyte accumulation, in areas of vascular injury and arterial thrombosis. (24,25) Furthermore, the binding of P-selectin to PSGL-1 on leukocytes mediates the rolling of leukocytes on adherent and activated platelets.…”