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Abstract: P315 PLATELET BEHAVIOUR IN PATIENTS WITH DRUG-ELUTING STENTS AFTER THIENOPYRIDINE TREATMENT DISCONTINUATION
Poster - CLINICAL ASPECTS OF CVD - Thrombosis Abstract: P315 Citation: Atherosclerosis Supplement 2009, Vol. 10, Issue 2
PLATELET BEHAVIOUR IN PATIENTS WITH DRUG-ELUTING STENTS AFTER THIENOPYRIDINE TREATMENT DISCONTINUATION M Camera1,2, D Villa1, D Trabattoni1, A Bartorelli1, P Bogani1, M Brambilla1, E Tremoli1,2 1
Centro Cardiologico Monzino IRCCS, Milan; 2Dpt. Of Pharmacological Sciences, University of Milan, Milan Dual antiplatelet therapy with aspirin and clopidogrel is standard of care following drug-eluting stents (DES) implantation. No data are available on platelet behaviour after stopping thienopyridine treatment. Objectives. To assess platelet activation during dual antiplatelet therapy (T0) and one month after thienopyridine discontinuation (T1) in patients treated with DES Methods. The expression of platelet activation markers (Glycoprotein IIb/IIIa activated complex [PAC-1], Tissue Factor [TF] and CD62P and the percentage of total and TF-positive monocyteplatelet aggregates) was assessed by whole blood flow cytometry in 37 stable angina (SA) patients treated with DES. As a comparison, platelet activation in 20 medically treated SA patients was analyzed Results. At T0, basal levels of platelet-associated PAC-1, TF and CD62P were significantly higher than medically treated SA patients (1.5, 2.5 and 2.2 fold respectively, p<0.02). Monocyteplatelet aggregates and TF-positive monocyte-platelet aggregates were more that two- and sixfold higher respectively. At T1, platelet-associated TF and PAC-1 expression was further upregulated (almost two fold compared to T0). Levels of CD62P, total and TF-positive monocyte-platelet aggregates did not change significantly. Conclusion. During dual antiplatelet therapy, platelet activation in DES patients is higher than in medically treated SA patients and further increases after thienopyridine discontinuation. This platelet behaviour may have implications for late DES thrombosis. Funding: This work was supported by the Italian Ministry of Health RC2006.
PLATELET BEHAVIOUR IN PATIENTS WITH DRUG-ELUTING STENTS AFTER THIENOPYRIDINE TREATMENT DISCONTINUATION M Camera1,2, D Villa1, D Trabattoni1, A Bartorelli1, P Bogani1, M Brambilla1, E Tremoli1,2 1
Centro Cardiologico Monzino IRCCS, Milan; 2Dpt. Of Pharmacological Sciences, University of Milan, Milan Dual antiplatelet therapy with aspirin and clopidogrel is standard of care following drug-eluting stents (DES) implantation. No data are available on platelet behaviour after stopping thienopyridine treatment. Objectives. To assess platelet activation during dual antiplatelet therapy (T0) and one month after thienopyridine discontinuation (T1) in patients treated with DES Methods. The expression of platelet activation markers (Glycoprotein IIb/IIIa activated complex [PAC-1], Tissue Factor [TF] and CD62P and the percentage of total and TF-positive monocyteplatelet aggregates) was assessed by whole blood flow cytometry in 37 stable angina (SA) patients treated with DES. As a comparison, platelet activation in 20 medically treated SA patients was analyzed Results. At T0, basal levels of platelet-associated PAC-1, TF and CD62P were significantly higher than medically treated SA patients (1.5, 2.5 and 2.2 fold respectively, p<0.02). Monocyteplatelet aggregates and TF-positive monocyte-platelet aggregates were more that two- and sixfold higher respectively. At T1, platelet-associated TF and PAC-1 expression was further upregulated (almost two fold compared to T0). Levels of CD62P, total and TF-positive monocyte-platelet aggregates did not change significantly. Conclusion. During dual antiplatelet therapy, platelet activation in DES patients is higher than in medically treated SA patients and further increases after thienopyridine discontinuation. This platelet behaviour may have implications for late DES thrombosis. Funding: This work was supported by the Italian Ministry of Health RC2006.