Role of activation-dependent platelet membrane glycoproteins in development of subacute occlusive coronary stent thrombosis.

Abstract:

BACKGROUND:Platelets have an important role in coronary thrombosis. METHODS:We studied 151 consecutive patients undergoing implantation of Palmaz-Schatz stents because of suboptimal results after coronary balloon angioplasty treated by intense anticoagulation. Surface exposure of the constitutively expressed glycoprotein complex IIb-IIIa (CD41), P-selectin (CD62P) and of the GPIIb-IIIa complex activated exposure (of ligand-induced binding site-1) were determined, in addition to platelet count and plasma fibrinogen, before and daily for 12 days after stenting in peripheral venous blood samples. RESULTS:Six of 151 patients (3.9%) developed subacute stent thrombosis within the first week after stenting. The relative risk of stent thrombosis was 18.5-fold for patients with enhanced GPIIb-IIIa surface expression (P < 0.003; 95% confidence interval 2.1 to 163.1) before stent placement. In the period after stenting, platelet activation occurred, with an increase in fibrinogen receptor activity and P-selectin degranulation above pre-stent values (P < 0.01). In logistic regression analysis, GPIIb-IIIa before stenting emerged as a risk factor for stent thrombosis, independent of the activational status of platelets, platelet count or fibrinogen levels (P < 0.02). However, after stenting, P-selectin surface expression acquired prognostic importance for stent thrombosis (P < 0.05). CONCLUSION:We conclude that changes in platelet membrane glycoproteins are of prognostic value in predicting subacute stent thrombosis.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Gawaz M,Neumann FJ,Ott I,May A,Rüdiger S,Schömig A

doi

10.1097/00019501-199703000-00001

subject

Has Abstract

pub_date

1997-03-01 00:00:00

pages

121-8

issue

3-4

eissn

0954-6928

issn

1473-5830

journal_volume

8

pub_type

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