title: Platelet density per monocyte predicts adverse events in patients after percutaneous coronary intervention.
abstract: Monocyte recruitment to damaged endothelium is enhanced by platelet binding to monocytes and contributes to vascular repair. Therefore, we studied whether the number of platelets per monocyte affects the recurrence of adverse events in patients after percutaneous coronary intervention (PCI). Platelet-monocytes complexes with high and low median fluorescence intensities (MFI) of the platelet marker CD42b were isolated using cell sorting. Microscopic analysis revealed that a high platelet marker MFI on monocytes corresponded with a high platelet density per monocyte while a low platelet marker MFI corresponded with a low platelet density per monocyte (3.4 ± 0.7 vs 1.4 ± 0.1 platelets per monocyte, P=0.01). Using real-time video microscopy, we observed increased recruitment of high platelet density monocytes to endothelial cells as compared with low platelet density monocytes (P=0.01). Next, we classified PCI scheduled patients (N=263) into groups with high, medium and low platelet densities per monocyte and assessed the recurrence of adverse events. After multivariate adjustment for potential confounders, we observed a 2.5-fold reduction in the recurrence of adverse events in patients with a high platelet density per monocyte as compared with a low platelet density per monocyte [hazard ratio=0.4 (95% confidence interval, 0.2-0.8), P=0.01]. We show that a high platelet density per monocyte increases monocyte recruitment to endothelial cells and predicts a reduction in the recurrence of adverse events in patients after PCI. These findings may imply that a high platelet density per monocyte protects against recurrence of adverse events.
authors.affiliation: Dr. Bert Rutten, Department of Clinical Chemistry and Haematology, UMC Utrecht, Utrecht, the Netherlands, E-mail: bertrutten@gmail.com.
authors.forename: Bert
authors.initials: B
authors.lastname: Rutten
authors.forename: Mark
authors.initials: M
authors.lastname: Roest
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: McClellan
authors.forename: Jan W
authors.initials: JW
authors.lastname: Sels
authors.forename: Andrew
authors.initials: A
authors.lastname: Stubbs
authors.forename: J Wouter
authors.initials: JW
authors.lastname: Jukema
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.forename: Johannes
authors.initials: J
authors.lastname: Waltenberger
authors.forename: Anton-Jan
authors.initials: AJ
authors.lastname: van Zonneveld
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
authors.forename: Philip G
authors.initials: PG
authors.lastname: De Groot
authors.forename: Imo E
authors.initials: IE
authors.lastname: Hoefer
mesh_terms: D001792:Blood Platelets / Q000166:cytology*; D002469:Cell Separation; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis; D005434:Flow Cytometry; D005456:Fluorescent Dyes / Q000737:chemistry; D061307:Human Umbilical Vein Endothelial Cells; D006801:Humans; D053208:Kaplan-Meier Estimate; D008856:Microscopy, Fluorescence; D018715:Microscopy, Video; D009000:Monocytes / Q000166:cytology*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000379:methods*; D010976:Platelet Count; D019038:Platelet Glycoprotein GPIb-IX Complex / Q000378:metabolism; D016016:Proportional Hazards Models
chemical_list: D005456:Fluorescent Dyes; D019038:Platelet Glycoprotein GPIb-IX Complex
keywords: Monocytes; adverse events; percutaneous coronary intervention; platelets