Could stent design affect platelet activation? Results of the Platelet Activation in STenting (PAST) Study.
Platelet activation induced by coronary artery stenting may be related to stent design. In a prospective, randomized pilot study of 54 elective patients, platelet activation was analyzed before and at 2 hours, 24 hours, 5 days and 30 days post-implantation of either a closed-cell (NIR) or open-cell (TETRA) stent. Platelet activation was less following NIR implantation as indicated by reduced aggregation to 5  mol adenosine diphosphate at 30 days (32.3   6.1% versus 94.5   18.9%; p = 0.02) and reduced expression of multiple surface markers (log mean fluorescence intensity): at 2 hours, CD 107a (22   13 versus 18   5; p = 0.045); at 24 hours, CD 31 (136   48 versus 110   48; p = 0.04), CD 151 (104   45 versus 91   31; p = 0.048), platelet leukocyte aggregates (95   40 versus 77   24; p = 0.018), and CD 107a (24   12 versus 17   4; p = 0.03); and at 30 days, CD 151 (99   33 versus 81   32; p = 0.03), platelet leukocyte aggregates (84   35 versus 72   31; p = 0.045) and PAC-1 (88   91 versus 72   30; p = 0.025). Ex vivo studies in explanted swine hearts revealed that the NIR stent produced less intimal prolapse and thus a smoother stent-vessel wall interface than the TETRA stent. In this pilot study, platelet activation was greater during the 30 days following implantation of an open-cell versus a closed-cell stent. This finding may be related to superior scaffolding, resulting in a smoother luminal contour after implantation of a closed-cell stent.
D000368:Aged; D000818:Animals; D015703:Antigens, CD / Q000097:blood; D003324:Coronary Artery Disease / Q000601:surgery; D004867:Equipment Design; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D010865:Pilot Projects; D015539:Platelet Activation / Q000502:physiology*; D010974:Platelet Aggregation; D011446:Prospective Studies; D015607:Stents / Q000009:adverse effects*; D013552:Swine
D015703:Antigens, CD