title: Coronary artery bypass graft surgery up-regulates genes involved in platelet aggregation.
abstract: BACKGROUND
  During and shortly after coronary artery bypass graft (CABG) surgery, there is an increase in thromboembolic events. CABG, a strong inflammatory stimulus, is associated with a hypercoaguable state. Platelets might contribute to this hypercoaguable state because they have a pivotal role in thrombosis. In the days following surgery there is augmented platelet regeneration in response to the inflammatory stimulus.
  
  
  OBJECTIVE
  The aim of this study was to investigate any changes in platelet mRNA profiles to test the hypothesis that post-CABG surgery platelets are associated with a prothrombotic state.
  
  
  METHODS
  Blood was sampled and platelets purified from 11 patients before and 3-6 days after CABG. Gene expression profiling was performed using low density array (LDA) plates for seven of the patients.
  
  
  RESULTS
  Forty-five genes were examined and those significantly up-regulated were glycoprotein (GP)IIb, GPIIIa and cyclooxygenase-1 (COX-1). These findings were confirmed in four more patients, including flow cytometry analysis of the GPIIb/IIIa receptor.
  
  
  CONCLUSIONS
  CABG surgery up-regulates mRNA and protein levels of proteins that are key players in platelet aggregation. Marked elevation of GPIIb/IIIa mRNA levels results in significantly increased GPIIb/IIIa expression in platelets post-CABG surgery, which may be a reason for increased thrombus formation and myocardial infarction after CABG.
authors.affiliation: Department of Medicine, Atherosclerosis Research Unit, Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Reilly
authors.forename: N
authors.initials: N
authors.lastname: Li
authors.forename: J
authors.initials: J
authors.lastname: Liska
authors.forename: M
authors.initials: M
authors.lastname: Ekström
authors.forename: P
authors.initials: P
authors.lastname: Tornvall
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000378:metabolism*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D051545:Cyclooxygenase 1 / Q000235:genetics; D005260:Female; D005434:Flow Cytometry; D020869:Gene Expression Profiling; D006801:Humans; D039421:Integrin alpha2 / Q000235:genetics; D039661:Integrin beta3 / Q000235:genetics; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology / Q000235:genetics; D010974:Platelet Aggregation / Q000235:genetics*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000235:genetics; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000235:genetics / Q000378:metabolism; D012333:RNA, Messenger / Q000097:blood; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden; D013927:Thrombosis / Q000097:blood / Q000209:etiology / Q000235:genetics*; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: C056564:ITGA2B protein, human; C061248:ITGB3 protein, human; D039421:Integrin alpha2; D039661:Integrin beta3; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D012333:RNA, Messenger; D051545:Cyclooxygenase 1; C496511:PTGS1 protein, human