title: Effect of Remote Ischemic Preconditioning on Platelet Activation Induced by Coronary Procedures.
abstract: In this study, we aim to assess whether remote ischemic preconditioning (RIPC) reduces platelet activation during coronary angiography (CA) and/or percutaneous coronary interventions. We studied 30 patients who underwent CA because of a suspect of stable angina. Patients were randomized to RIPC (3 short episodes of forearm ischemia) or sham RIPC (controls) before the procedure. Blood samples were collected at baseline, at the end of the procedure, and 24 hours later. Monocyte-platelet aggregate (MPA) formation and platelet CD41 in the MPA gate and CD41 and CD62 expression in the platelet gate were assessed by flow cytometry, in the absence and in the presence of adenosine diphosphate (ADP) stimulation. A significant increase in platelet activation occurred during the invasive procedure in controls, which persisted at 24 hours. However, compared with controls, RIPC group showed no or a lower increase in platelet variables, including MPA formation (p <0.0001) and CD41 (p = 0.002) in the MPA gate and CD41 (p <0.0001) and CD62 (p = 0.002) in the platelet gate. ADP increased platelet activation at baseline, but did not further increase platelet reactivity during the invasive procedure in either groups. Percutaneous coronary interventions, performed in 10 patients (6 in the RIPC group and 4 in controls), did not have any further significant effect on platelet activation and reactivity compared with CA alone. In conclusion, RIPC reduces platelet activation occurring during CA. In contrast, no effects were observed on platelet response to ADP stimulation, probably related to the administration of an ADP antagonist in all patients.
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: g.a.lanza@rm.unicatt.it.
authors.forename: Gaetano Antonio
authors.initials: GA
authors.lastname: Lanza
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Stazi
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Villano
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Torrini
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Milo
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Marianna
authors.initials: M
authors.lastname: Laurito
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Flego
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Aurigemma
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Liuzzo
authors.affiliation: Department of Cardiovascular Sciences, Institute of Cardiology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000009:adverse effects*; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D019157:Ischemic Preconditioning, Myocardial / Q000379:methods*; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood / Q000209:etiology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D015539:Platelet Activation / Q000502:physiology*; D010974:Platelet Aggregation; D013686:Telemetry / Q000379:methods*; D016896:Treatment Outcome