In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.


The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Platelet reactivity and circulating platelet-derived microvesicles in patients with acute coronary syndrome following dual antiplatelet treatment

Session Refining antithrombotic therapy in coronary artery disease

Speaker Sam Kafian

Congress : ESC Congress 2014

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Acute Coronary Syndromes - Pathophysiology and Mechanisms
  • Session type : Moderated Posters
  • FP Number : P1070

Authors : S Kafian (Stockholm,SE), F Mobarrez (Stockholm,SE), H Wallen (Stockholm,SE), B Samad (Stockholm,SE)

Authors:
S. Kafian1 , F. Mobarrez2 , H. Wallen1 , B. Samad1 , 1Danderyd University Hospital, Cardiology - Stockholm - Sweden , 2Danderyd University Hospital, Clinical Sciences, Division of Cardiovascular Medicine - Stockholm - Sweden ,

Citation:
European Heart Journal ( 2014 ) 35 ( Abstract Supplement ), 191

Purpose: Dual antiplatelet therapy (DAT) with aspirin and P2Y12 receptor inhibitors is the treatment of choice in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Platelets and platelet-derived microvesicles (PMVs) play a crucial role in the arterial thrombotic process. Measuring platelet function is methodologically demanding and measurement of PMVs could therefore offer an additional method to assess platelet function in previously frozen and stored samples from large biobanks. In the present study we investigated how platelet function measured with multiplate and PMVs measured by flow cytometry were affected by clopidogrel treatment in patients with ACS and PCI.

Methods: 200 patients with ACS who underwent PCI were included in the study and venous blood samples were obtained at discharge. All patients were loaded with 600 mg clopidogrel before PCI. Platelets were activated with ADP (6.4 mM) and analysed by whole blood impedance aggregometry (WBA; MultiplateTM). Aggregation ≥47 U (WBA) defined low responders to DAT.

PMVs were measured by flow cytometry (Beckman Gallios) in samples prepared from stored platelet poor plasma (2000g, 20 min in room temperature). Twenty μl of sample were incubated with lactadherin-FITC and CD42a-PE (platelet antigen GPIX) and CD62P-APC (P-selectin).

Results: Platelet function measured with WBA revealed that 35 of 180 patients (19%) were low responders and 148 (81%) patients were normal responders with clopidogrel treatment. Levels of PMVs were almost two fold higher in the low responder group compared to patient that responded well to treatment (for both CD42a and CD62P, positive PMVs, p<0.005 and p<0.004 respectively).

Conclusions: Patients with high on clopidogrel treatment platelet reactivity have elevated levels of circulating PMVs, indicating ongoing platelet activation despite DAT. PMVs can be used as biomarkers to assess platelet function in plasma samples from large prospective clinical studies.



Based on your interests

Members get more

Join now
  • 1ESC Professional Members – access all resources from ESC Congress and ESC Asia with APSC & AFC
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s congress resources
  • 3Under 40 or in training - with a Combined Membership, access resources from all congresses
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are