Abstract
The early identification of patients with heightened platelet activity for aggressive antiplatelet regimens represents a critical clinical issue in acute myocardial infarction (AMI) therapy. We sought to determine whether the degree of pre-reperfusion platelet function is related to subsequent activity following thrombolysis. Platelets were investigated at baseline and at 24 h following thrombolytic therapy by aggregometry, and flow cytometry in 19 AMI patients enrolled in the GUSTO-III trial. Regression analysis revealed a significant correlation for 5 microM ADP (r2 = 0.529), 10 microM ADP (r2 = 0.445), thrombin (r2 = 0.226), collagen (r2 = 0.568), and ristocetin-induced aggregation (r2 = 0.964). Platelet expression linearly correlated for GPIIb/IIIa (r2 = 0.337), P-selectin (r = 0.817), PECAM-1 (r2 = 0.586), and the vitronectin receptor (r2 = 0.634). The data suggest that the baseline characteristics predict future platelet activity, and may prospectively identify patients who will benefit most from antiplatelet strategies after coronary thrombolysis.
Publication types
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Clinical Trial
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Clinical Trial, Phase III
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Comparative Study
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Biomarkers / blood
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Blood Platelets / drug effects
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Blood Platelets / physiology*
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Female
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Flow Cytometry
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Humans
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Male
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Middle Aged
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Myocardial Infarction / blood
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Myocardial Infarction / drug therapy*
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P-Selectin / blood
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P-Selectin / drug effects
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Pilot Projects
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Platelet Aggregation / drug effects
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Platelet Aggregation / physiology*
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Platelet Aggregation Inhibitors / therapeutic use*
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Platelet Count
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Platelet Endothelial Cell Adhesion Molecule-1 / blood*
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Platelet Endothelial Cell Adhesion Molecule-1 / drug effects
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Platelet Glycoprotein GPIIb-IIIa Complex / drug effects
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Platelet Glycoprotein GPIIb-IIIa Complex / metabolism
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Platelet Membrane Glycoproteins / drug effects
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Platelet Membrane Glycoproteins / metabolism*
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Prognosis
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Prospective Studies
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Receptors, Vitronectin / blood*
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Receptors, Vitronectin / drug effects
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Thrombolytic Therapy*
Substances
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Biomarkers
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P-Selectin
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Platelet Aggregation Inhibitors
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Platelet Endothelial Cell Adhesion Molecule-1
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Platelet Glycoprotein GPIIb-IIIa Complex
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Platelet Membrane Glycoproteins
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Receptors, Vitronectin