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Thromb Haemost 2004; 91(01): 141-145
DOI: 10.1160/TH03-06-0341
Platelets and Blood Cells
Schattauer GmbH

PlA polymorphism of the glycoprotein IIIa and efficacy of reperfusion therapy in patients with acute myocardial infarction

Olga Gorchakova
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
,
Werner Koch
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
,
Julinda Mehilli
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
,
Nicolas von Beckerath
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
,
Markus Schwaiger
2   Klinik und Poliklinik für Nuklearmedizin rechts der Isar, Technische Universität München, Munich, Germany
,
Albert Schömig
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
,
Adnan Kastrati
1   Deutsches Herzzentrum and 1. Medizinische Klinik rechts der Isar
› Author Affiliations
Further Information

Publication History

Received 04 June 2003

Accepted after revision 17 October 2003

Publication Date:
30 November 2017 (online)

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Summary

The PlA polymorphism of the platelet glycoprotein IIIa gene is associated with altered platelet function and response to antiplatelet drugs. We sought to assess whether the PlA polymorphism influences myocardial salvage achieved by reperfusion therapy in patients with acute myocardial infarction. We analyzed 292 patients enrolled in 2 randomized trials that compared stenting plus abciximab with thrombolysis (alteplase alone or alteplase plus abciximab) in acute myocardial infarction. Patients were genotyped for the PlA polymorphism using polymerase chain reaction with fluorogenic probes. Technetium-99m sestamibi was injected before and 1-2 weeks after reperfusion treatment. The scintigrams enabled the calculation of the initial perfusion defect, final infarct size, and the proportion of initial defect salvaged by reperfusion (salvage index). Clinical follow-up was done up to 18 months after primary treatment. The genotype distribution was as follows: PlA2/A2 in 3.4%, PlA1/A2 in 24.7% and PlA1/A1 in 71.9% of patients. There were no significant differences between PlA2 allele carriers and PlA1/A1 patients in salvage index (0.46±0.50 vs. 0.41±0.43, respectively, P=0.48), final infarct size (16.8±20.8% vs. 18.4±19.1% of left ventricle, respectively, P=0.46) as well as 18-month mortality (8.5% vs.7.1%, respectively, P=0.69). The lack of relationship between PlA2 allele and myocardial salvage was observed for both reperfusion strategies, stenting and thrombolysis. Thus, these findings show that the functional PlA polymorphism of platelet glycoprotein IIIa has no influence on the degree of myocardial salvage achieved by reperfusion therapies in patients with acute myocardial infarction.

Keywords

PlA polymorphism - glycoprotein IIIa - platelets - acute myocardial infarction - reperfusion
 

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