Platelet activation and high tissue factor level predict acute stent thrombosis in pig coronary arteries: Prothrombogenic response of drug-eluting or bare stent implantation within the first 24 hours

Mariann Gyöngyösi; Christoph Strehblow; Wolfgang Sperker; Akos Hevesi; Rita Garamvölgyi; Zsolt Petrási; Noemi Pavo; Péter Ferdinandy; Csaba Csonka; Tamás Csont; Christer Sylvén; Paul J. Declerck; Pavo Imre Jr.; Johann Wojta; Dietmar Glogar; Kurt Huber

doi:10.1160/TH06-03-0178

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2006; 96(02): 202-209
DOI: 10.1160/TH06-03-0178

Animal Models

Schattauer GmbH

Platelet activation and high tissue factor level predict acute stent thrombosis in pig coronary arteries: Prothrombogenic response of drug-eluting or bare stent implantation within the first 24 hours

Mariann Gyöngyösi

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Christoph Strehblow

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Wolfgang Sperker

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Akos Hevesi

²Institute of Diagnostic Imaging and Radiation Oncology, University of Kaposvar, Kaposvar Hungary

,

Rita Garamvölgyi

²Institute of Diagnostic Imaging and Radiation Oncology, University of Kaposvar, Kaposvar Hungary

,

Zsolt Petrási

²Institute of Diagnostic Imaging and Radiation Oncology, University of Kaposvar, Kaposvar Hungary

,

Noemi Pavo

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Péter Ferdinandy

³Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Hungary

,

Csaba Csonka

³Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Hungary

,

Tamás Csont

³Cardiovascular Research Group, Department of Biochemistry, University of Szeged, Hungary

,

Christer Sylvén

⁴Department of Cardiology, Karolinska University Hospital at Huddinge, Karolinska Institutet, Stockholm, Sweden

,

Paul J. Declerck

⁵Laboratory for Pharmaceutical Biology and Phytopharmacology, Faculty of Pharmaceutical Sciences, Katholieke Universiteit Leuven, Belgium

,

Pavo Imre Jr.

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Johann Wojta

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Dietmar Glogar

¹Department of Cardiology, Medical University of Vienna, Vienna, Austria

,

Kurt Huber

⁶3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminenhospital, Vienna, Austria

› Author Affiliations

Abstract

Summary

Increased thrombogenicity of drug-eluting stents (DESs) has recently been reported.The aim of the present study was to investigate the prothrombogenic effect of DESs and Bare stents, and determine factors predictive of acute stent thrombosis (AST) in preclinical experiments using new stent design or coating.Circulating preand post-stenting parameters of platelet activation (mean platelet volume, MPV; platelet distribution width, platelet large cell ratio), thrombin activation (thrombin-antithrombin complex, TAT and prothrombin fragments, F1+2), tissue factor antigen (TF-ag) and -activity (TF-act) and plasminogen activator inhibitor-1 (PAI-1) were measured in 141 consecutive pigs. Stent implantations were performed after pretreatment with aspirin and clopidogrel with unfractionated heparin anticoagulation. Nineteen pigs (groups AST-DES, n=12; and AST-Bare, n=7) died mean 6.3 ± 2.9 h after stent implantation from AST.The remaining 122 control (C) pigs (groups C-DES,n=76,and C-Bare,n=46) survived the 1-month follow-up. Non-significantly elevated levels of post-stent F1+2 and TAT were measured in AST groups. Post-stenting MPV was increased significantly in the groups ASTDES and AST-Bare as compared with the groups C-DES and C-Bare (11.73 ± 1.12 and 11.6 ± 0.68 vs. 8.85 ± 0.78 and 9.04 ± 0.81 fL; p<0.001), similarly toTF-ag (189.1± 87.5 and 127 ± 34.9 vs. 42.5 ± 24.6 and 35.3 ± 37.6 pg/ml; p<0.001, respectively),TF-act (3.23 ± 0.95 and 2.73 ± 1.68 vs. 1.43 ± 1.12 and 1.61 ± 1.31 pM; p<0.01, respectively) and PAI-1 (99.1 ± 15.8 and 99 ± 14.7 vs.53.4 ± 40.2 and 46.9 ± 42.4 ng/ml;p<0.01,respectively).Multivariate analysis revealed elevated post-stenting plasma levels of TF-ag (p=0.016) and MPV (p=0.001) as independent risk factors for developing AST within the first 24 h in a porcine coronary stent model.

Keywords

Platelets - stents - thrombosis - coronary circulation - tissue factor

Full Text

References

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