1
|
Pedersen OB, Pasalic L, Nissen PH, Grove EL, Kristensen SD, Hvas AM. Flow Cytometric Assessment of Changes in Platelet Reactivity after Acute Coronary Syndrome: A Systematic Review. Semin Thromb Hemost 2022; 48:542-551. [PMID: 35226948 DOI: 10.1055/s-0042-1742742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Increased platelet activity is an important predictor for recurrent cardiovascular events in patients with acute coronary syndromes (ACS). Flow cytometry is an advanced method for evaluation of platelet activity. We aimed to summarize the current literature on dynamic changes in platelet activity analyzed by flow cytometry in patients with ACS. Employing the guidelines of Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched PubMed and Embase on October 26, 2021, and identified studies measuring platelet activity with flow cytometry in ACS patients in the acute phase (baseline) and at follow-up in a more stable phase. In the 12 included studies, fibrinogen receptor, α-granule secretion, platelet reactivity index, monocyte-platelet aggregates, neutrophil-platelet aggregates, and reticulated platelets were measured. The fibrinogen receptor and α-granule secretion were either unchanged or lower during follow-up measurements than in the acute phase. Platelet reactivity index showed inconsistent results. Values of monocyte-platelet aggregates and neutrophil-platelet aggregates were lower at follow-up than at baseline (p-values <0.05). Reticulated platelets were either unchanged (p-value >0.64) or lower at 1 to 2 months follow-up (p-value 0.04), and also lower at 5 months to 1-year follow-up (p-value >0.005) compared with baseline. Overall, flow cytometric analyses of platelet function in ACS patients showed that platelet activity was lower at follow-up than at baseline. However, in some patients, platelet activity remained unchanged from baseline to follow-up, possibly indicating a sustained high platelet activity that may increase the risk of recurrent cardiovascular events.
Collapse
Affiliation(s)
- Oliver Buchhave Pedersen
- Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.,Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Leonardo Pasalic
- Institute of Clinical Pathology and Medical Research, Departments of Clinical and Laboratory Hematology, Westmead University Hospital, Sydney, Australia
| | - Peter H Nissen
- Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Erik Lerkevang Grove
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Steen Dalby Kristensen
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Anne-Mette Hvas
- Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark
| |
Collapse
|
2
|
Ortega-Paz L, Galli M, Capodanno D, Brugaletta S, Angiolillo DJ. The Role of Antiplatelet Therapy in Patients With MINOCA. Front Cardiovasc Med 2022; 8:821297. [PMID: 35237672 PMCID: PMC8882905 DOI: 10.3389/fcvm.2021.821297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022] Open
Abstract
Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a heterogeneous group of clinical entities characterized by the common clinical evidence of myocardial infarction (MI) with non-obstructive coronary arteries on coronary angiography and without an overt cause for the MI. Platelets play a cornerstone role in the pathophysiology of MI with obstructive coronary arteries. Accordingly, antiplatelet therapy is recommended for treating patients with MI and obstructive coronary disease. However, the role of platelets in the pathophysiology of MINOCA patients is not fully defined, questioning the role of antiplatelet therapy in this setting. In this review, we will assess the role of antiplatelet therapy in MINOCA with a focus on the pathophysiology, therapeutic targets, current evidence, and future directions according to its different etiologies.
Collapse
Affiliation(s)
- Luis Ortega-Paz
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States
- Cardiovascular Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Mattia Galli
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States
- Cardiovascular Medicine, Fondazione Policlinico Universitario A Gemelli Scientific Institute for Research, Hospitalization and Healthcare, Rome, Italy
| | - Davide Capodanno
- Division of Cardiology, Azienda Ospedaliero Universitaria Policlinico “G. Rodolico-San Marco” University of Catania, Catania, Italy
| | - Salvatore Brugaletta
- Cardiovascular Institute, Hospital Clinic, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - Dominick J. Angiolillo
- Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL, United States
- *Correspondence: Dominick J. Angiolillo ; orcid.org/0000-0001-8451-2131
| |
Collapse
|
3
|
Pluta K, Porębska K, Urbanowicz T, Gąsecka A, Olasińska-Wiśniewska A, Targoński R, Krasińska A, Filipiak KJ, Jemielity M, Krasiński Z. Platelet-Leucocyte Aggregates as Novel Biomarkers in Cardiovascular Diseases. BIOLOGY 2022; 11:biology11020224. [PMID: 35205091 PMCID: PMC8869671 DOI: 10.3390/biology11020224] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/19/2022] [Accepted: 01/24/2022] [Indexed: 12/18/2022]
Abstract
Simple Summary Cardiovascular diseases are the most common cause of death worldwide. Hence, novel biomarkers are urgently needed to improve diagnosis and treatment. Platelet–leucocyte aggregates are conglomerates of platelets and leucocytes and are widely investigated as biomarkers in cardiovascular diseases. Platelet–leucocytes aggregates are present in health, but increase in patients with cardiovascular risk factors and acute or stable coronary syndromes, making them a potential diagnostic marker. Moreover, platelet–leucocyte aggregates predict outcomes after surgery or percutaneous treatment and could be used to monitor antiplatelet therapy. Emerging data about the participation of platelet–leucocyte aggregates in cardiovascular diseases pathogenesis make them an attractive target for novel therapies. Furthermore, simple detection with conventional flow cytometry provides accurate and reproducible results, although requires specific sample handling. The main task for the future is to determine the standardized protocol to measure blood concentrations of platelet–leucocyte aggregates and subsequently establish their normal range in health and disease. Abstract Platelet–leucocyte aggregates (PLA) are a formation of leucocytes and platelets bound by specific receptors. They arise in the condition of sheer stress, thrombosis, immune reaction, vessel injury, and the activation of leukocytes or platelets. PLA participate in cardiovascular diseases (CVD). Increased levels of PLA were revealed in acute and chronic coronary syndromes, carotid stenosis cardiovascular risk factors. Due to accessible, available, replicable, quick, and low-cost quantifying using flow cytometry, PLA constitute an ideal biomarker for clinical practice. PLA are promising in early diagnosing and estimating prognosis in patients with acute or chronic coronary syndromes treated by percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). PLA were also a reliable marker of platelet activity for monitoring antiplatelet therapy. PLA consist also targets potential therapies in CVD. All of the above potential clinical applications require further studies to validate methods of assay and proof clinical benefits.
Collapse
Affiliation(s)
- Kinga Pluta
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
| | - Kinga Porębska
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
| | - Tomasz Urbanowicz
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Aleksandra Gąsecka
- 1st Chair and Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (K.P.); (K.P.)
- Correspondence: ; Tel.: +48-22-599-1951
| | - Anna Olasińska-Wiśniewska
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Radosław Targoński
- 1st Department of Cardiology, Medical University of Gdansk, 80-210 Gdansk, Poland;
| | - Aleksandra Krasińska
- Department of Ophtalmology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| | - Krzysztof J. Filipiak
- Department of Clinical Sciences, Maria Sklodowska-Curie Medical Academy in Warsaw, 00-136 Warsaw, Poland;
| | - Marek Jemielity
- Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, 61-701 Poznan, Poland; (T.U.); (A.O.-W.); (M.J.)
| | - Zbigniew Krasiński
- Department of Vascular and Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Sciences, 61-701 Poznan, Poland;
| |
Collapse
|
4
|
Elevated platelet-leukocyte complexes are associated with, but dispensable for myocardial ischemia-reperfusion injury. Basic Res Cardiol 2022; 117:61. [PMID: 36383299 PMCID: PMC9668925 DOI: 10.1007/s00395-022-00970-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 10/18/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
AIMS P-selectin is an activatable adhesion molecule on platelets promoting platelet aggregation, and platelet-leukocyte complex (PLC) formation. Increased numbers of PLC are circulating in the blood of patients shortly after acute myocardial infarction and predict adverse outcomes. These correlations led to speculations about whether PLC may represent novel therapeutic targets. We therefore set out to elucidate the pathomechanistic relevance of PLC in myocardial ischemia and reperfusion injury. METHODS AND RESULTS By generating P-selectin deficient bone marrow chimeric mice, the post-myocardial infarction surge in PLC numbers in blood was prevented. Yet, intravital microscopy, flow cytometry and immunohistochemical staining, echocardiography, and gene expression profiling showed unequivocally that leukocyte adhesion to the vessel wall, leukocyte infiltration, and myocardial damage post-infarction were not altered in response to the lack in PLC. CONCLUSION We conclude that myocardial infarction associated sterile inflammation triggers PLC formation, reminiscent of conserved immunothrombotic responses, but without PLC influencing myocardial ischemia and reperfusion injury in return. Our experimental data do not support a therapeutic concept of selectively targeting PLC formation in myocardial infarction.
Collapse
|
5
|
Persistent circulating platelet and endothelial derived microparticle signature may explain on-going pro-thrombogenicity after acute coronary syndrome. Thromb Res 2021; 206:60-65. [PMID: 34418680 DOI: 10.1016/j.thromres.2021.07.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 07/02/2021] [Accepted: 07/31/2021] [Indexed: 11/23/2022]
Abstract
AIMS Microparticles (MPs) are submicron vesicles, released from activated, and apoptotic cells. MPs are elevated in the circulation of patients with coronary artery disease (CAD) and have pro-thrombotic potential. However, limited data exists on MP signature over time following an acute coronary event. METHODS & RESULTS Circulating total annexin v + (Anv+) MPs of endothelial (EMP), platelet (PMP), monocyte (MMP), neutrophil (NMP) and smooth muscle cell (SMMP) origin were quantified by flow cytometry. 13 patients with acute coronary syndrome (ACS) were prospectively enrolled and 12 patients with stable angina (SA) were included as a comparator group. A panel of MP was measured at baseline, after percutaneous coronary intervention (PCI) and at days 1, 7, 30 and 6 months. Intra & inter group comparison was made between various time points. MP mediated thrombin generation was measured by recording lag phase, velocity index, peak thrombin and endogenous thrombin potential at these time points and compared with healthy controls. The total AnV+ MP levels were similar in ACS and SA groups at baseline, peaked immediately after PCI and were at their lowest on day 1. PMP & EMP levels remained significantly elevated in ACS patients at 6 months when compared to SA. No such difference was noted with NMP, MMP and SMMP. Patients with coronary artery disease showed abnormal thrombograms when compared to controls. Peak thrombin (nano moles) was significantly higher in CAD when compared to controls (254 IQR [226, 239] in ACS, 255 IQR [219, 328] in SA and 132 IQR [57, 252] in controls; p = 0.006). Differences in thrombin generation between ACS and SA were not significant (p = 1). Furthermore, thrombin parameters remained abnormal in ACS & SA patients at 6 months. CONCLUSIONS Total MP and individual MP phenotypes were significantly elevated after PCI reflecting endothelial injury. Elevated PMP and EMP levels at 6 months in ACS patients is suggestive of on-going inflammation, endothelial injury and may explain on-going pro-thrombogenicity seen up to 6 months after ACS despite dual antiplatelet therapy.
Collapse
|
6
|
Gartshteyn Y, Mor A, Shimbo D, Khalili L, Kapoor T, Geraldino-Pardilla L, Alexander RV, Conklin J, Dervieux T, Askanase AD. Platelet bound complement split product (PC4d) is a marker of platelet activation and arterial vascular events in Systemic Lupus Erythematosus. Clin Immunol 2021; 228:108755. [PMID: 33984497 DOI: 10.1016/j.clim.2021.108755] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 11/25/2022]
Abstract
Platelet-bound complement activation products (PC4d) are associated with thrombosis in Systemic Lupus Erythematosus (SLE). This study investigated the effect of PC4d on platelet function, as a mechanistic link to arterial thrombosis. In a cohort of 150 SLE patients, 13 events had occurred within five years of enrollment. Patients with arterial events had higher PC4d levels (13.6 [4.4-24.0] vs. 4.0 [2.5-8.3] net MFI), with PC4d 10 being the optimal cutoff for event detection. The association of arterial events with PC4d remained significant after adjusting for antiphospholipid status, smoking, and prednisone use (p = 0.045). PC4d levels correlated with lower platelet counts (r = -0.26, p = 0.002), larger platelet volumes (r = 0.22, p = 0.009) and increased platelet aggregation: the adenosine diphosphate (ADP) concentration to achieve 50% maximal aggregation (EC50) was lower in patients with PC4d 10 compared with PC4d < 10 (1.6 vs. 3.7, p = 0.038, respectively). These results suggest that PC4d may be a mechanistic marker for vascular disease in SLE.
Collapse
Affiliation(s)
- Yevgeniya Gartshteyn
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America.
| | - Adam Mor
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| | - Daichi Shimbo
- Center for Behavioral Cardiovascular Health, Division of Cardiology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| | - Leila Khalili
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| | - Teja Kapoor
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| | - Laura Geraldino-Pardilla
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| | | | - John Conklin
- Exagen Diagnostics Inc, Vista, CA, United States of America
| | | | - Anca D Askanase
- Division of Rheumatology, Department of Medicine, Columbia University Medical Center, New York, NY, United States of America
| |
Collapse
|
7
|
Circulating miR-660-5p is associated with no-reflow phenomenon in patients with ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Anatol J Cardiol 2020; 25:323-329. [PMID: 33960307 DOI: 10.14744/anatoljcardiol.2020.29267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE This study aims to investigate the association of circulating miR-660-5p with no-reflow phenomenon (NRP) in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS Consecutive patients diagnosed with anterior STEMI within 12 h of pain onset were included; in these patients, coronary angiography confirmed that the left anterior descending artery was infarcted. Angiographic NRP was defined as a final thrombolysis in myocardial infarction (TIMI) flow 2 or 3 with a myocardial blush grade (MBG) <2. High miR-660-5p was defined as a value in the third tertile. The relationship of circulating miR-660-5p with NRP was assessed using Spearman correlation analysis and multiple logistic regression analysis. RESULTS Fifty-two eligible patients were finally included in this study (mean age: 56±12.4 years, >65 years: 53.8%, male: 76.9%, and mean Body Mass Index: 26.3±3.5). The incidence of NRP was 38.5%. Circulating miR-660-5p was significantly related to the mean platelet volume (MPV). The patients were grouped into tertiles by miR-660-5p levels (Q1: <7.18, Q2: 7.18-11.31, Q3: >11.31). Those in the high microRNA-660-5p group had nearly a 6-fold higher risk of NRP than those in the low microRNA-660-5p group [odds ratio (OR) = 5.68, 95% confidence interval (CI) 1.40-23.07, p=0.015]. When analyzed by tertiles, relative odds of NRP were consistently increasing (OR1 for Q2 vs. Q1: 1.25, 95% CI: 0.27-5.73, p=0.770; OR2 for Q3 vs. Q1: 5.96, 95% CI: 1.33-26.66, p=0.02), despite multivariable adjustment. Receiver operating characteristic curve analysis demonstrated that the microRNA-660-5p level of 10.17 was the best cut-off level to predict the incidence of the NRP in patients undergoing PPCI with an area under the ROC curve (AUC) of 0.768 (95% CI: 0.636-0.890). CONCLUSION Circulating miR-660-5p was significantly associated with NRP, and it may be a useful biomarker to predict the incidence of NRP in patients with STEMI undergoing PPCI.
Collapse
|
8
|
Sezer M, van Royen N, Umman B, Bugra Z, Bulluck H, Hausenloy DJ, Umman S. Coronary Microvascular Injury in Reperfused Acute Myocardial Infarction: A View From an Integrative Perspective. J Am Heart Assoc 2019; 7:e009949. [PMID: 30608201 PMCID: PMC6404180 DOI: 10.1161/jaha.118.009949] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Murat Sezer
- 1 Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | | | - Berrin Umman
- 1 Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Zehra Bugra
- 1 Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| | - Heerajnarain Bulluck
- 3 The Hatter Cardiovascular Institute Institute of Cardiovascular Science University College London London United Kingdom.,4 Papworth Hospital NHS Trust Cambridge United Kingdom
| | - Derek J Hausenloy
- 3 The Hatter Cardiovascular Institute Institute of Cardiovascular Science University College London London United Kingdom.,4 Papworth Hospital NHS Trust Cambridge United Kingdom.,5 National Heart Research Institute Singapore National Heart Centre Singapore Singapore.,6 Cardiovascular and Metabolic Disorders Program Duke-National University of Singapore Singapore.,7 Yong Loo Lin School of Medicine National University Singapore Singapore.,8 The National Institute of Health Research University College London Hospitals Biomedical Research Centre London United Kingdom.,9 Barts Heart Centre St Bartholomew's Hospital London United Kingdom
| | - Sabahattin Umman
- 1 Istanbul Faculty of Medicine Istanbul University Istanbul Turkey
| |
Collapse
|
9
|
Maimaiti A, Li Y, Wang YT, Yang X, Li XM, Yang YN, Ma YT. Association of platelet-to-lymphocyte count ratio with myocardial reperfusion and major adverse events in patients with acute myocardial infarction: a two-centre retrospective cohort study. BMJ Open 2019; 9:e025628. [PMID: 31537554 PMCID: PMC6756339 DOI: 10.1136/bmjopen-2018-025628] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Insufficient myocardial reperfusion for patients with acute myocardial infarction (AMI) during primary percutaneous coronary intervention (PPCI) has a great influence on prognosis. The aim of this study was to investigate the association of the platelet-to-lymphocyte ratio (PLR) with myocardial reperfusion and in-hospital major adverse cardiac events (MACEs) in patients with AMI undergoing PPCI. DESIGN Retrospective cohort study. SETTING Patients and researchers from two tertiary hospitals. PARTICIPANTS A total of 445 consecutive AMI patients who underwent PPCI between January 2015 and December 2017 were enrolled. Patients were divided into two groups based on the PLR value: patients with PLR values in the third tertile were defined as the high-PLR group (n=150), and those in the lower two tertiles were defined as the low-PLR group (n=295). Explicit criteria for inclusion and exclusion were applied. INTERVENTIONS No interventions. PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures were defined as cardiovascular death, reinfarction or target vessel revascularisation. Secondary outcome measures were defined as stroke, non-lethal myocardial infarction, ventricular tachycardia/ventricular fibrillation and in-hospital mortality. RESULTS The high-PLR group had insufficient myocardial perfusion (23% vs 13%, p=0.003), greater postprocedural thrombolysis in myocardial infarction flow grade (0-2) (17% vs 10%, p=0.037), greater myocardial blush grade (0-1) (11% vs 4%, p=0.007) and higher B-type natriuretic peptide (BNP) (614±600 vs 316±429, p<0.001) compared with the low-PLR group. Multivariate logistic regression analysis indicated that the independent risk factors for impaired myocardial perfusion were high PLR (OR 1.256, 95% CI 1.003 to 1.579, p=0.056) and high BNP (OR 1.328, 95% CI 1.056 to 1.670, p=0.015). The high-PLR group had significantly more MACEs (43% vs 32%, p=0.029). CONCLUSIONS This study suggested that high PLR and BNP were independent risk factors for insufficient myocardial reperfusion in patients with AMI. Higher PLR was related to advanced heart failure and in-hospital MACEs in patients with AMI undergoing PPCI.
Collapse
Affiliation(s)
- Ailifeire Maimaiti
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yang Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yong-Tao Wang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiang Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Xiao-Mei Li
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Ning Yang
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yi-Tong Ma
- Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| |
Collapse
|
10
|
Kannan M, Ahmad F, Saxena R. Platelet activation markers in evaluation of thrombotic risk factors in various clinical settings. Blood Rev 2019; 37:100583. [DOI: 10.1016/j.blre.2019.05.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 05/11/2019] [Accepted: 05/20/2019] [Indexed: 12/12/2022]
|
11
|
Fuentes E, Moore-Carrasco R, de Andrade Paes AM, Trostchansky A. Role of Platelet Activation and Oxidative Stress in the Evolution of Myocardial Infarction. J Cardiovasc Pharmacol Ther 2019; 24:509-520. [DOI: 10.1177/1074248419861437] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Myocardial infarction, commonly known as heart attack, evolves from the rupture of unstable atherosclerotic plaques to coronary thrombosis and myocardial ischemia–reperfusion injury. A body of evidence supports a close relationship between the alterations following an ischemia–reperfusion injury-induced oxidative stress and platelet activity. Through their critical role in thrombogenesis and inflammatory responses, platelets are fully (totally) implicated from atherothrombotic plaque formation to myocardial infarction onset and expansion. However, mere platelet aggregation prevention does not offer full protection, suggesting that other antiplatelet therapy mechanisms may also be involved. Thus, the present review discusses the integrative role of platelets, oxidative stress, and antiplatelet therapy in triggering myocardial infarction pathophysiology.
Collapse
Affiliation(s)
- Eduardo Fuentes
- Thrombosis Research Center, Medical Technology School, Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Center on Aging, Universidad de Talca, Talca, Chile
| | - Rodrigo Moore-Carrasco
- Departamento de Bioquímica Clínica e Inmunohematología, Facultad de Ciencias de la Salud, Programa de Investigación Asociativa en Cáncer Gástrico (PIA-CG), Universidad de Talca, Talca, Chile
| | - Antonio Marcus de Andrade Paes
- Laboratory of Experimental Physiology, Health Sciences Graduate Program and Department of Physiological Sciences, Federal University of Maranhão, São Luís, Brazil
| | - Andres Trostchansky
- Departamento de Bioquímica and Center for Free Radical and Biomedical Research, Facultad de Medicina, Universidad de la República, Montevideo, Uruguay
| |
Collapse
|
12
|
Ozawa K, Packwood W, Varlamov O, Qi Y, Xie A, Wu MD, Ruggeri Z, López J, Lindner JR. Molecular Imaging of VWF (von Willebrand Factor) and Platelet Adhesion in Postischemic Impaired Microvascular Reflow. Circ Cardiovasc Imaging 2018; 11:e007913. [PMID: 30571316 PMCID: PMC6309798 DOI: 10.1161/circimaging.118.007913] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 09/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Complete mechanistic understanding of impaired microvascular reflow after myocardial infarction will likely lead to new therapies for reducing infarct size. Myocardial contrast echocardiography perfusion imaging and molecular imaging were used to evaluate the contribution of microvascular endothelial-associated VWF (von Willebrand factor) and platelet adhesion to microvascular no-reflow. METHODS AND RESULTS Myocardial infarction was produced by transient LAD ligation in WT (wild type) mice, WT mice treated with the VWF proteolytic enzyme ADAMTS13 (a disintegrin and metalloproteinase with thrombospondin type 1 motif, member 13), and ADAMTS13-deficient (ADAMTS13-/-) mice. Myocardial contrast echocardiography perfusion imaging and molecular imaging of VWF and platelet GP (glycoprotein) Ibα were performed 30 minutes after ischemia-reperfusion. Infarct size was measured at 3 days. Mortality during ischemia-reperfusion incrementally increased in WT+ADAMTS13, WT, and ADAMTS13-/- mice (14%, 43%, and 63%, respectively; P<0.05). For WT mice, molecular imaging signal for platelets and VWF in the postischemic risk area was 4- to 5-fold higher ( P<0.05) compared with both the remote nonischemic regions or to sham-treated mice. Signal enhancement in the risk area was completely abolished by ADAMTS13 treatment for both platelets (12.8±3.3 versus -1.0±4.4 IU; P<0.05) and VWF (13.9±4.0 versus -1.0±3.0 IU; P<0.05). ADAMTS13-/- compared with WT mice had 2- to 3-fold higher risk area signal for platelets (33.1±8.5 IU) and VWF (30.9±1.9 IU). Microvascular reflow in the risk area incrementally decreased for WT+ADAMTS13, WT, and ADAMTS13-/- mice ( P<0.05), whereas infarct size incrementally increased ( P<0.05). CONCLUSIONS Mechanistic information on microvascular no-reflow is possible by combining perfusion and molecular imaging. In reperfused myocardial infarction, excess endothelial-associated VWF and secondary platelet adhesion in the risk area microcirculation contribute to impaired reflow and are modifiable.
Collapse
Affiliation(s)
- Koya Ozawa
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - William Packwood
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Oleg Varlamov
- Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR
| | - Yue Qi
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Aris Xie
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
| | - Melinda D. Wu
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
- Doernbecher’s Children’s Hospital, Oregon Health & Science University, Portland, OR
| | - Zaverio Ruggeri
- Department of Molecular & Experimental Medicine, Scripps Research Institute, La Jolla, CA
| | | | - Jonathan R. Lindner
- Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR
- Oregon National Primate Research Center, Oregon Health & Science University, Portland, OR
| |
Collapse
|
13
|
Koganti S, Eleftheriou D, Brogan PA, Kotecha T, Hong Y, Rakhit RD. Microparticles and their role in coronary artery disease. Int J Cardiol 2017; 230:339-345. [DOI: 10.1016/j.ijcard.2016.12.108] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Revised: 12/04/2016] [Accepted: 12/17/2016] [Indexed: 12/16/2022]
|
14
|
Vannini L, Muro A, Sanchis J, Ortiz-Pérez JT, Flores Umanzor E, López-Lereu MP, Badimon L, Sabaté M, Brugaletta S. Can new generation P2Y12 inhibitors play a role in microvascular obstruction in STEMI? Int J Cardiol 2016; 223:226-227. [PMID: 27541661 DOI: 10.1016/j.ijcard.2016.08.182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 08/08/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Luca Vannini
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | - Anna Muro
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | - Juan Sanchis
- Cardiology Department, Hospital Clínico Universitario, Valencia, School of Medicine, Universitat de València, Valencia, Spain
| | - Josè T Ortiz-Pérez
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | - Eduardo Flores Umanzor
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | - Maria Pilar López-Lereu
- Cardiology Department, Hospital Clínico Universitario, Valencia, School of Medicine, Universitat de València, Valencia, Spain
| | - Lina Badimon
- Cardiovascular Research Center (CSIC-ICCC), IIB-Sant Pau, UAB, Barcelona, Spain
| | - Manel Sabaté
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain
| | - Salvatore Brugaletta
- Department of Cardiology, Clinic Cardiovascular Institute, Hospital Clinic, Barcelona, Spain.
| |
Collapse
|
15
|
Liang WY, Liu ML, Feng XR, Zhang ZL, Zhu XY, Li YJ, Liu A, Yin HJ. Effect of Shen-yuan on haemodynamic and anti-inflammatory factors in a porcine model of acute myocardial infarction. Eur Heart J Suppl 2016. [DOI: 10.1093/eurheartj/suw003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
|
16
|
Pfluecke C, Berndt K, Wydra S, Tarnowski D, Barthel P, Quick S, Ulbrich S, Christoph M, Waessnig N, Speiser U, Wunderlich C, Poitz DM, Strasser RH, Ibrahim K. Atrial fibrillation is associated with high levels of monocyte-platelet-aggregates and increased CD11b expression in patients with aortic stenosis. Thromb Haemost 2016; 115:993-1000. [PMID: 26763077 DOI: 10.1160/th15-06-0477] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 12/10/2015] [Indexed: 11/05/2022]
Abstract
A growing body of evidence suggests a pivotal role of inflammatory processes in AF in a bidirectional manner. Infiltrating leukocytes seem to promote both structural and electrical remodelling processes in patients with AF. Monocyte-platelets-aggregates (MPAs) are sensitive markers of both platelets and monocyte activation. So far it is not clear whether the content of MPAs is affected by AF. The present study examined the content of MPAs and the activation of monocytes in elderly patients with an aortic stenosis in dependence of AF. These patients are known to have a high prevalence of AF. Flow-cytometric quantification analysis demonstrated that patients with AF have an increased content of MPAs (207 ± 13 cells/µl vs 307 ± 21 cells/µl, p< 0.001), and enhanced expression of CD11b on monocytes (p< 0.001), compared to patients in stable sinus rhythm (SR). The number of CD14+/CD16+ monocytes were only slightly elevated in patients with AF. These findings were seen in patients with permanent AF. But also patients with paroxysmal AF, even when presenting in SR, the MPAs were increased by 50 % (p< 0.05) as well as the CD11b expression, which was twice as high (p< 0.05) compared to stable SR. These results demonstrate for the first time a dependency of MPAs and CD11b expression on monocytes in the presence of AF and support the notion of a close relationship between AF, thrombogenesis and inflammation. The content of MPAs and the extent of activation on monocytes appear promising as biomarkers for paroxysmal AF and as possible future targets for developing novel pharmacological therapeutic strategies.
Collapse
Affiliation(s)
- Christian Pfluecke
- Dr. med. Christian Pfluecke, Fetscherstrasse 76, 01307 Dresden, Germany, Tel.: +49 351 4500, Fax: +49 351 450 1702, E-mail:
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Cameron SJ, Ture SK, Mickelsen D, Chakrabarti E, Modjeski KL, McNitt S, Seaberry M, Field DJ, Le NT, Abe JI, Morrell CN. Platelet Extracellular Regulated Protein Kinase 5 Is a Redox Switch and Triggers Maladaptive Platelet Responses and Myocardial Infarct Expansion. Circulation 2015; 132:47-58. [PMID: 25934838 DOI: 10.1161/circulationaha.115.015656] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 04/27/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Platelets have a pathophysiologic role in the ischemic microvascular environment of acute coronary syndromes. In comparison with platelet activation in normal healthy conditions, less attention is given to mechanisms of platelet activation in diseased states. Platelet function and mechanisms of activation in ischemic and reactive oxygen species-rich environments may not be the same as in normal healthy conditions. Extracellular regulated protein kinase 5 (ERK5) is a mitogen-activated protein kinase family member activated in hypoxic, reactive oxygen species-rich environments and in response to receptor-signaling mechanisms. Prior studies suggest a protective effect of ERK5 in endothelial and myocardial cells after ischemia. We present evidence that platelets express ERK5 and that platelet ERK5 has an adverse effect on platelet activation via selective receptor-dependent and receptor-independent reactive oxygen species-mediated mechanisms in ischemic myocardium. METHODS AND RESULTS Using isolated human platelets and a mouse model of myocardial infarction (MI), we found that platelet ERK5 is activated post-MI and that platelet-specific ERK5(-/-) mice have less platelet activation, reduced MI size, and improved post-MI heart function. Furthermore, the expression of downstream ERK5-regulated proteins is reduced in ERK5(-/-) platelets post-MI. CONCLUSIONS ERK5 functions as a platelet activator in ischemic conditions, and platelet ERK5 maintains the expression of some platelet proteins after MI, leading to infarct expansion. This demonstrates that platelet function in normal healthy conditions is different from platelet function in chronic ischemic and inflammatory conditions. Platelet ERK5 may be a target for acute therapeutic intervention in the thrombotic and inflammatory post-MI environment.
Collapse
Affiliation(s)
- Scott J Cameron
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Sara K Ture
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Deanne Mickelsen
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Enakshi Chakrabarti
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Kristina L Modjeski
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Scott McNitt
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Michael Seaberry
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - David J Field
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Nhat-Tu Le
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Jun-Ichi Abe
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.)
| | - Craig N Morrell
- From Aab Cardiovascular Research Institute, University of Rochester School of Medicine, NY (S.J.C., S.K.T., D.M., E.C., K.L.M., M.S., D.J.F., C.N.M.); Department of Medicine (S.J.C., C.N.M.) and Heart Research Follow-Up Program (S.M.), Division of Cardiology, University of Rochester School of Medicine, NY; and Department of Cardiology Research, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston (N.-T.L., J.-i.A.).
| |
Collapse
|