Circulation, Vol 88, 37-42, Copyright © 1993 by American Heart Association
D Tschoepe, HP Schultheiss, P Kolarov, B Schwippert, K Dannehl, HK Nieuwenhuis, B Kehrel, B Strauer and FA Gries
BACKGROUND. We wished to investigate whether platelet activation is related
to the clinical outcome during the 24 hours immediately after elective
percutaneous transluminal coronary angioplasty (PTCA). METHODS AND RESULTS.
In 102 patients with high-grade coronary stenosis admitted for elective
PTCA, preprocedural platelet activation was characterized by flow
cytometric measurement of the proteins CD62, CD63, and thrombospondin
expressed on the platelet surface membrane. The prevalence of acute
ischemic events during the 24 hours immediately after the procedure was
then related to the pre-PTCA platelet activation status. Fifty-six patients
were classified as "nonactivated," whereas 46 patients showed an increased
percentage of activated platelets. Two patients developed acute occlusion
(1.96%) and four patients high-grade restenosis (3.92%), as confirmed by
second- look coronary angiography. All events occurred in patients
classified as "activated" (six of 46, or 13%). None of these patients
received beta-blocker medication, which was associated with lower
expression of platelet membrane activation markers. In the nonactivated
patient group, no clinical events were found (0 of 56, or 0%). This
difference in prevalence is significant (p = 0.007). CONCLUSIONS. We
conclude that analysis of platelet membrane activation markers may help to
predict an increased risk of acute ischemic events after angioplasty.
ARTICLES
Platelet membrane activation markers are predictive for increased risk of acute ischemic events after PTCA
Diabetes Research Institute, Heinrich Heine University, Dusseldorf, FRG.
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