Carotid versus coronary stent revascularization : comparison of the platelet activation profile
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Data di Pubblicazione:
2010
Citazione:
Carotid versus coronary stent revascularization : comparison of the platelet activation profile / P. Canzano, E. Tirloni, P. Montorsi, M. Brambilla, D. Trabattoni, S. Ghulam Ali, A. Bartorelli, E. Tremoli, M. Camera. ((Intervento presentato al convegno Next Step: la giovane ricerca avanza tenutosi a Milano nel 2010.
Abstract:
Background. Platelet activation occurs in both coronary and carotid artery stenting as a result of vessel wall damage and subendothelium exposure. The dual antiplatelet regimen (aspirin+thienopyridine) has a significant impact on reducing stent thrombosis and adverse outcomes. Whether differences exist in the degree of platelet activation among stent-treated coronary and carotid vessel is not known. Aim. To compare platelet activation in patients who underwent carotid versus coronary revascularization. Methods. 20 patients with high-grade carotid artery stenosis and 20 stable angina patients who underwent revascularization with bare metal stent implantation were studied. To assess platelet function, blood was withdrawn 1 month (T1) after stenting procedure and 2 months after thienopyridine discontinuation (T2). Platelet activation markers (PAC1, CD62 and Tissue Factor [TF] and the percentage of monocyte-platelet aggregates [MPA]) were assessed by whole blood flow cytometry in resting conditions and upon in vitro ADP stimulation. Results. One month after revascularization, CD62 and PAC1 positive (+) platelets were comparable in carotid and coronary-treated patients. By contrast, TF+ platelets as well as TF+ MPA were 3 fold higher in coronary vs carotid-treated patients, both under resting conditions and upon ADP stimulation (p<0.001). At T2, when thienopyridine was discontinued, the platelet activation profile was comparable to that observed at T1, with TF+ platelets and TF+ MPA being still significantly higher (2-3 fold) in coronary vs carotid-treated patients, both under resting conditions and upon ADP stimulation (p<0.01). No significant differences in the platelet activation markers expression were observed between T1 and T2 both in carotid- as well as in coronary-treated patients. Conclusions. Significant higher levels of TF+ platelets and TF+ MPA were observed in peripheral blood of coronary patients who underwent revascularization with stent implantation compared to patients with carotid artery stenting, both 1 month after stenting and 2 months after thienopyridine discontinuation. This prothrombotic platelet phenotype may have implications for thrombotic complications in coronary patients.
Tipologia IRIS:
14 - Intervento a convegno non pubblicato
Keywords:
Carotid revascularization; coronary revascularization; stent; platelets
Elenco autori:
P. Canzano, E. Tirloni, P. Montorsi, M. Brambilla, D. Trabattoni, S. Ghulam Ali, A. Bartorelli, E. Tremoli, M. Camera
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