title: In Vivo and protease-activated receptor-1-mediated platelet activation in patients presenting for cardiac catheterization.
abstract: Pathways of platelet activation that are not targeted by current antithrombotic therapy may be crucial for the development of ischemic events in patients undergoing coronary angiography. We therefore investigated whether in vivo and thrombin receptor activating peptide (TRAP)-stimulated platelet activation and monocyte-platelet aggregate (MPA) levels can serve as independent risk markers for adverse outcomes in aspirin-treated patients presenting for cardiac catheterization. In vivo and TRAP-stimulated platelet surface P-selectin, activated glycoprotein IIb/IIIa (GPIIb/IIIa) and MPA levels were determined in 682 consecutive patients undergoing cardiac catheterization and in 47 healthy controls. Two-year follow-up data were obtained from 562 patients. In vivo platelet surface P-selectin, activated GPIIb/IIIa and MPA levels were significantly higher in patients with angiographically-proven coronary artery disease than in healthy controls (all p≤0.02). Patients with an acute coronary syndrome (ACS; n=125) had significantly higher levels of in vivo MPA than patients without ACS (n=437; p=0.01). In the overall study population (n=562) the surface expression of P-selectin and activated GPIIb/IIIa, and the levels of MPA in vivo and in response to TRAP were similar in patients without and with subsequent ischemic events (all p>0.05). Similar results were obtained when only patients with angiographically-proven coronary artery disease (n=459), stent implantation (n=205) or ACS (n=125) were analyzed. Receiver-operating characteristic curve analyses did not reveal cut-off values for P-selectin, activated GPIIb/IIIa, and MPA levels for the prediction of ischemic events. In conclusion, in vivo and TRAP-stimulated platelet activation and MPA levels did not predict adverse ischemic outcomes in aspirin-treated patients presenting for cardiac catheterization.
authors.affiliation: a Division of Hematology/Oncology , Center for Platelet Research Studies, Boston Children´s Hospital, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA.|b Department of Internal Medicine II , Medical University of Vienna , Vienna , Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gremmel
authors.affiliation: a Division of Hematology/Oncology , Center for Platelet Research Studies, Boston Children´s Hospital, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA.
authors.forename: Alan D
authors.initials: AD
authors.lastname: Michelson
authors.affiliation: a Division of Hematology/Oncology , Center for Platelet Research Studies, Boston Children´s Hospital, Dana-Farber Cancer Institute, Harvard Medical School , Boston , MA , USA.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Frelinger
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D000368:Aged; D015415:Biomarkers; D001792:Blood Platelets / Q000187:drug effects / Q000378:metabolism*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism; D016017:Odds Ratio; D019007:P-Selectin / Q000378:metabolism; D015539:Platelet Activation / Q000187:drug effects; D010974:Platelet Aggregation / Q000187:drug effects; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000378:metabolism; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D012372:ROC Curve; D044463:Receptor, PAR-1 / Q000378:metabolism*; D018179:Receptors, Thrombin / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D019007:P-Selectin; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D010980:Platelet Membrane Glycoproteins; D044463:Receptor, PAR-1; D018179:Receptors, Thrombin
keywords: Cardiac catheterization; Platelet activation; protease-activated receptor-1