title: β-blockers are associated with decreased leucocyte-platelet aggregate formation and lower residual platelet reactivity to adenosine diphosphate after angioplasty and stenting.
abstract: BACKGROUND
  The beneficial effects of β-blockers on the long-term prognosis of patients with cardiovascular disease may in part be attributable to decreased platelet activation. In this prospective cohort study, we sought to investigate the impact of concomitant β-blocker therapy on sensitive markers of platelet activation and aggregation.
  
  
  METHODS
  Monocyte-platelet (MPA) and neutrophil-platelet aggregate (NPA) formation in vivo and in response to the platelet agonist adenosine diphosphate (ADP) were determined by flow cytometry in 258 patients undergoing angioplasty and stenting. On-treatment residual platelet reactivity to ADP was assessed by multiple electrode aggregometry (MEA).
  
  
  RESULTS
  One hundred seventy-five patients of the study population (67·8%) received β-blockers. Treatment with β-blockers was associated with significantly lower MPA and NPA formation in vivo and in response to ADP compared to patients without β-blockers (all P ≤ 0·01). The inverse associations of MPA and NPA formation with β-blocker therapy remained statistically significant after adjustment for differences in patient characteristics by multivariate linear regression analyses (all P < 0·05). Moreover, high levels of MPA in response to ADP as well as high levels of NPAin vivo and in response to ADP were significantly less frequent in patients with β-blocker treatment (all P < 0·05). Finally, on-treatment residual platelet reactivity to ADP by MEA was significantly lower in patients receiving β-blockers (P = 0·005).
  
  
  CONCLUSIONS
  β-Blockers are associated with decreased leucocyte-platelet aggregate formation and lower on-treatment residual platelet reactivity to ADP in patients with dual antiplatelet therapy following angioplasty and stenting.
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Silvia
authors.initials: S
authors.lastname: Lee
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Markus
authors.initials: M
authors.lastname: Durstberger
authors.affiliation: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Beate
authors.initials: B
authors.lastname: Eichelberger
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Christoph W
authors.initials: CW
authors.lastname: Kopp
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.affiliation: Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Simon
authors.initials: S
authors.lastname: Panzer
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gremmel
mesh_terms: D000244:Adenosine Diphosphate / Q000494:pharmacology*; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D017130:Angioplasty; D001792:Blood Platelets / Q000187:drug effects*; D016022:Case-Control Studies; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000187:drug effects*; D015999:Multivariate Analysis; D009504:Neutrophils / Q000187:drug effects*; D010974:Platelet Aggregation / Q000187:drug effects*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D015607:Stents
chemical_list: D000319:Adrenergic beta-Antagonists; D010975:Platelet Aggregation Inhibitors; D000244:Adenosine Diphosphate
keywords: Angioplasty; clopidogrel; leucocyte-platelet aggregates; stent implantation; β-blockers