• Please log in or register to access this feature.

ORIGINAL ARTICLE

Periprocedural variations of platelet reactivity during elective percutaneous coronary intervention

  1. F. MANGIACAPRA1,
  2. J. BARTUNEK1,
  3. N. BIJNENS2,
  4. A. J. PEACE1,
  5. K. DIERICKX1,
  6. E. BAILLEUL3,
  7. L. DI SERAFINO1,
  8. S. A. PYXARAS1,
  9. A. FRAEYMAN3,
  10. P. MEEUS3,
  11. M. RUTTEN2,
  12. B. DE BRUYNE1,
  13. W. WIJNS1,
  14. F. VAN de VOSSE2,
  15. E. BARBATO1

Article first published online: 12 DEC 2012

DOI: 10.1111/jth.12016

Issue

Journal of Thrombosis and Haemostasis

Journal of Thrombosis and Haemostasis

Volume 10, Issue 12, pages 2452–2461, December 2012

Additional Information

How to Cite

MANGIACAPRA, F., BARTUNEK, J., BIJNENS, N., PEACE, A. J., DIERICKX, K., BAILLEUL, E., DI SERAFINO, L., PYXARAS, S. A., FRAEYMAN, A., MEEUS, P., RUTTEN, M., DE BRUYNE, B., WIJNS, W., VAN de VOSSE, F. and BARBATO, E. (2012), Periprocedural variations of platelet reactivity during elective percutaneous coronary intervention. Journal of Thrombosis and Haemostasis, 10: 2452–2461. doi: 10.1111/jth.12016

Author Information

  1. 1

    Cardiovascular Center Aalst OLV Hospital, Aalst, Belgium

  2. 2

    Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands

  3. 3

    Department of Hematology, OLV Hospital, Aalst, Belgium

*Emanuele Barbato, Cardiovascular Center Aalst, OLV Clinic, Moorselbaan 164, B-9300 Aalst, Belgium. Tel.: +32 53 724 447; fax: +32 53 724550. E-mail: emanuele.barbato@olvz-aalst.be

Publication History

  1. Issue published online: 12 DEC 2012
  2. Article first published online: 12 DEC 2012
  3. Accepted manuscript online: 5 OCT 2012 11:33AM EST
  4. Received 3 August 2012, accepted 10 September 2012

SEARCH

SEARCH BY CITATION

ARTICLE TOOLS

View Full Article (HTML) Get PDF (380K)

Keywords:

  • antiplatelet drug resistance;
  • clopidogrel;
  • endothelial function;
  • percutaneous coronary intervention;
  • periprocedural myocardial infarction

Summary.  Background: Percutaneous coronary intervention (PCI) modulates platelet reactivity (PR). Objectives: To assess: (i) the impact of coronary interventions on periprocedural variations (Δ) of PR; (ii) whether ΔPR correlates with periprocedural myocardial infarction (PMI); and (iii) the mechanisms of these variations in vitro. Methods and results: We enrolled 65 patients on aspirin (80–100 mg day−1) and clopidogrel (600 mg, 12 h before PCI): 15 with coronary angiography (CA group), 40 with PCI (PCI group), and 10 with rotational atherectomy plus PCI (RA group). PR was assessed by ADP, high-sensitivity ADP and thrombin receptor activator peptide 6 tests prior to, immediately after and 24 h after the procedure. E-selectin and ICAM-1 were assessed prior to and immediately after the procedure. In vitro, PR was measured during pulsatile blood flow at baseline, after balloon inflation and after stent implantation in six porcine carotid arteries and five plastic tubes. PR declined in the CA group, but significantly increased in the PCI and RA groups immediately postprocedure, and decreased to baseline at 24 h. ΔPR increased across the three groups (P < 0.0001). In the PCI group, ΔPR was directly related to total inflation time (r = 0.435, P = 0.005) and total stent length (r = 0.586, P < 0.001). The change in E-selectin significantly and inversely correlated with ΔPR (P < 0.001). No correlation was found with sICAM-1. PR increased significantly more in patients with PMI than in patients without PMI (P = 0.013). In vitro, platelet activation was observed in the presence of carotid arteries but not in the presence of plastic tubes. Conclusions: Despite dual antiplatelet therapy, PCI affected platelet function proportionally to procedural complexity and the extent of vascular damage.

View Full Article (HTML) Get PDF (380K)