Authors: Morel O.; Hugel B.; Jesel L.¹; Mallat Z.²; Lanza F.³; Douchet M-P.¹; Zupan M.¹; Chauvin M.¹; Cazenave J-P.³; Tedgui A.²; Freyssinet J-M.; Toti F.

Source: Journal of Thrombosis and Haemostasis, Volume 2, Number 7, July 2004 , pp. 1118-1126(9)

Publisher: Wiley-Blackwell

Abstract:

Summary.

Circulating procoagulant microparticles (MP) were measured as markers of vascular damage and prothrombotic risk in patients undergoing ST-segment myocardial infarction (STEMI) treated by primary percutaneous transluminal coronary angioplasty (PTCA) and additional GPIIb-IIIa antagonists. Cells possibly more responsive to GPIIb-IIIa (_IIb3) antagonists were evidenced through MP phenotypes by comparison with healthy volunteers (HV) and STEMI patients treated by PTCA without GPIIb-IIIa antagonist (CP). In 50 STEMI patients, blood samples were collected at day 1 and day 6. Circulating procoagulant MP were captured on annexin V and quantified by prothrombinase assay as nanomolar phosphatidylserine equivalents (nmPhtdSer). Platelet activation by thrombin was confirmed through independent measurement of soluble GPV (sGPV). With respect to HV, procoagulant MP levels were high in patients with STEMI or unstable angina, platelet-derived MP and elevated sGPV testifying to significant platelet activation. A substantial release of endothelial-derived MP was evidenced simultaneously. In abciximab-treated patients, procoagulant MP, mainly of platelet origin, decreased precociously at day 1 (4.2 ± 0.6 vs. CP 15.5 ± 2.1 nmPhtdSer; P = 0.001) together with sGPV (36 ± 3 vs. CP 58 ± 8 ng mL^-1; P = 0.02). Leukocyte-derived MP decreased at day 6 (0.12 ± 0.04 vs. CP 0.56 ± 0.12 nmPhtdSer; P = 0.01) suggesting a possible effect on underlying inflammatory status. In patients presenting cardiovascular events at 6-month follow-up, procoagulant MP levels at day 1 could be indicative of a worsened outcome. MP could constitute a relevant parameter for the follow-up of STEMI patients treated by GPIIb-IIIa antagonists.

Keywords: abciximab; acute coronary syndrome; eptifibatide; thrombosis

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1538-7836.2004.00805.x

Affiliations: 1: Fédération de Cardiologie des Hôpitaux Universitaires de Strasbourg 2: U.541 INSERM, Paris, France 3: U.311 INSERM Etablissement Français du Sang-Alsace, Strasbourg, France

Publication date: 2004-07-01

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• By this author: Morel O. ;  Hugel B. ;  Jesel L. ;  Mallat Z. ;  Lanza F. ;  Douchet M-P. ;  Zupan M. ;  Chauvin M. ;  Cazenave J-P. ;  Tedgui A. ;  Freyssinet J-M. ;  Toti F.

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