Elevations in soluble CD40 ligand in patients with high platelet aggregability undergoing percutaneous coronary intervention

High aggregatory responses despite antiplatelet treatment is associated with an increased risk of thrombotic complications following percutaneous coronary intervention (PCI). In the present study, we investigated the relationship between platelet aggregatory responses to ADP and the release of CD40L...

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Bibliographic Details
Published in:	Blood coagulation & fibrinolysis Vol. 20; no. 4; pp. 283 - 289
Main Authors:	Obradovic, Slobodan D, Antovic, Jovan P, Antonijevic, Nebojsa M, Ratkovic, Nenad G, Vojvodic, Danilo V, Subota, Vesna S, Gligic, Branko Lj, Obradovic, Dragana V, Marinkovic, Jelena M, Wallen, Håkan N
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-06-2009 Lippincott Williams & Wilkins
Subjects:	Acute Coronary Syndrome - blood Acute Coronary Syndrome - therapy Adenosine Diphosphate - pharmacology Aged Biological and medical sciences Blood coagulation. Blood cells Cardiac Catheterization CD40 Ligand - blood Female Fundamental and applied biological sciences. Psychology Hematologic and hematopoietic diseases Humans Immunologic Factors - blood Male Medical sciences Medicin och hälsovetenskap Middle Aged Molecular and cellular biology P-Selectin - blood Platelet Aggregation Platelet diseases and coagulopathies Risk Factors Thrombosis - blood Human Angioplasty Cell adhesion molecule Instrumentation therapy Thienopyridine Soluble form platelet aggregation Aggregation P Selectin Platelet percutaneous coronary intervention soluble P-selectin Hemostasis CD40 ligand Platelet function thienopyridines soluble CD40-ligand
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Summary:	High aggregatory responses despite antiplatelet treatment is associated with an increased risk of thrombotic complications following percutaneous coronary intervention (PCI). In the present study, we investigated the relationship between platelet aggregatory responses to ADP and the release of CD40L (sCD40L)an immunomodulatory compound involved in atherothrombosis – in patients undergoing PCI. ADP-induced platelet aggregation, sCD40L and soluble P-selectin (sP-selectin) were determined before and 24 h after PCI, in samples from 52 patients receiving aspirin and thienopyridines. Platelet aggregation to ADP above the median was defined as ‘high aggregation’, and aggregation below the median as ‘low aggregation’. Data below are medians and interquartile ranges. Patients with ‘high platelet aggregability’ had a significantly higher increase in both sCD40L (Δ-values0.78 (−0.19–3.18) vs. −0.65 (−2.10–0.00) ng/ml, P = 0.002) and sP-selectin (Δ-values8.0 (−2.00–16.00) vs. 4.50 (−13.00–0.50) ng/ml, P = 0.001) compared with patients with ‘low platelet aggregability’. In a multivariate linear regression analysis adjusted for clinical characteristics and type of preintervention therapy, the only independent predictors of sCD40L and sP-selectin were platelet aggregation to ADP before PCI (P < 0.001) and the combination of platelet aggregation to ADP before PCI and urgency of PCI (P < 0.001). Circulating CD40L is more markedly increased after PCI in patients with high ADP-induced platelet aggregation.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0957-5235 1473-5733 1473-5733
DOI:	10.1097/MBC.0b013e328329f28c