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NEUTROPHIL-DERIVED MICROPARTICLES ARE RELEASED INTO THE CORONARY CIRCULATION FOLLOWING CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME PATIENTS
396 JACC April 5, 2016 Volume 67, Issue 13
ACC.i2 Interventional Cardiology NEUTROPHIL-DERIVED MICROPARTICLES ARE RELEASED INTO THE CORONARY CIRCULATION FOLLOWING CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME PATIENTS Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: Hemodynamics and Miscellaneous Abstract Category: 1. ACC.i2 Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology Presentation Number: 1254-167 Authors: Jennifer Barraclough, Gonzalo J. Martínez, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David Celermajer, Sanjay Patel, Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia, Heart Research Institute, Sydney, Australia
Background: Microparticles (MP) are small vesicles originating from the plasma membranes of cells after activation or apoptosis and are implicated in the pathogenesis of atherosclerosis. Neutrophils play a role in plaque destabilization and shed neutrophil-derived MP have the potential to drive significant pro-inflammatory and thrombotic downstream effects. In this study we evaluated coronary and systemic levels of MP in Acute Coronary Syndrome (ACS) and Stable Angina Pectoris (SAP) patients before and after plaque disruption with Percutaneous Coronary Intervention (PCI). Methods: 8 ACS and 8 SAP patients were included. Coronary sinus samples pre-intervention (CS1), 45sec following balloon angioplasty (CS2) and at 45 second intervals following stent deployment (CS3, CS4, CS5), together with peripheral vein samples, pre and postintervention were analyzed for neutrophil-derived (CD66b+), endothelial-derived (CD144+), platelet-derived (CD41a+), monocyte-derived (CD14+), and apoptotic (Annexin V +) MP. ELISA for IL-6, MPO and P-Selectin was also performed.
Results: Neutrophil-derived MP levels were similar in both groups pre-intervention. Post-PCI, coronary sinus levels rose significantly in ACS but not SAP patients (ACS AUC: 549 83, SAP AUC: 24 29p<0.01). Similarly MPO pre-intervention coronary sinus levels were comparable in both groups, but rose significantly in ACS patients (ACS AUC 71.2 ± 25.9 vs SAP AUC 2.3 ± 9.8, p = 0.03) post-intervention. Coronary sinus platelet-derived MP levels rose but not significantly in ACS patients (ACS CS1 1053 791.8 events/uL, ACS CS5 1757 1676 events/uL, p = 0.08). Endothelial-derived, monocyte-derived and apoptotic MP were similar between groups, with no change after PCI. Conclusions: Acute neutrophil-derived MP and MPO release post PCI occurs in ACS but not in stable patients, likely reflective of neutrophil activity in vulnerable lesions. These changes were only seen in the coronary sinus, demonstrating the importance of sampling the local cardiac micro-environment.
ACC.i2 Interventional Cardiology NEUTROPHIL-DERIVED MICROPARTICLES ARE RELEASED INTO THE CORONARY CIRCULATION FOLLOWING CORONARY INTERVENTION IN ACUTE CORONARY SYNDROME PATIENTS Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: Hemodynamics and Miscellaneous Abstract Category: 1. ACC.i2 Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology Presentation Number: 1254-167 Authors: Jennifer Barraclough, Gonzalo J. Martínez, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David Celermajer, Sanjay Patel, Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia, Heart Research Institute, Sydney, Australia
Background: Microparticles (MP) are small vesicles originating from the plasma membranes of cells after activation or apoptosis and are implicated in the pathogenesis of atherosclerosis. Neutrophils play a role in plaque destabilization and shed neutrophil-derived MP have the potential to drive significant pro-inflammatory and thrombotic downstream effects. In this study we evaluated coronary and systemic levels of MP in Acute Coronary Syndrome (ACS) and Stable Angina Pectoris (SAP) patients before and after plaque disruption with Percutaneous Coronary Intervention (PCI). Methods: 8 ACS and 8 SAP patients were included. Coronary sinus samples pre-intervention (CS1), 45sec following balloon angioplasty (CS2) and at 45 second intervals following stent deployment (CS3, CS4, CS5), together with peripheral vein samples, pre and postintervention were analyzed for neutrophil-derived (CD66b+), endothelial-derived (CD144+), platelet-derived (CD41a+), monocyte-derived (CD14+), and apoptotic (Annexin V +) MP. ELISA for IL-6, MPO and P-Selectin was also performed.
Results: Neutrophil-derived MP levels were similar in both groups pre-intervention. Post-PCI, coronary sinus levels rose significantly in ACS but not SAP patients (ACS AUC: 549 83, SAP AUC: 24 29p<0.01). Similarly MPO pre-intervention coronary sinus levels were comparable in both groups, but rose significantly in ACS patients (ACS AUC 71.2 ± 25.9 vs SAP AUC 2.3 ± 9.8, p = 0.03) post-intervention. Coronary sinus platelet-derived MP levels rose but not significantly in ACS patients (ACS CS1 1053 791.8 events/uL, ACS CS5 1757 1676 events/uL, p = 0.08). Endothelial-derived, monocyte-derived and apoptotic MP were similar between groups, with no change after PCI. Conclusions: Acute neutrophil-derived MP and MPO release post PCI occurs in ACS but not in stable patients, likely reflective of neutrophil activity in vulnerable lesions. These changes were only seen in the coronary sinus, demonstrating the importance of sampling the local cardiac micro-environment.