High-shear- and-thrombin-inducible platelet adhesion and aggregation in patients undergoing percutaneous coronary intervention

Roza Badr Eslam; Nina Reiter; Alexandra Kaider; Irene M. Lang; Simon Panzer

doi:10.1160/TH10-06-0384

Thrombosis and Haemostasis, Inhaltsverzeichnis

Thromb Haemost 2011; 105(03): 496-500
DOI: 10.1160/TH10-06-0384

Platelets and Blood Cells

Schattauer GmbH

High-shear- and-thrombin-inducible platelet adhesion and aggregation in patients undergoing percutaneous coronary intervention

Effects of unfractionated heparin versus bivalirudin

Roza Badr Eslam

¹Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria

,

Nina Reiter

²Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria

,

Alexandra Kaider

³Core Unit for Medical Statistics and Informatics, Section of Clinical Biometrics, Medical University of Vienna, Vienna, Austria

,

Irene M. Lang^*

¹Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Vienna, Austria

,

Simon Panzer^*

²Department of Blood Group Serology and Transfusion Medicine, Medical University of Vienna, Vienna, Austria

› Institutsangaben

Abstract

Summary

Thrombin-generation and activation of platelets during percutaneous coronary intervention (PCI) play a key role for early thrombotic events. Heparin and bivalirudin are approved anticoagulants for PCI. We examined the specific effects of these anticoagulants on platelet adhesion and aggregation under high shear conditions, and the presence of excess thrombin. To simulate in vivo conditions that may precipitate a bleeding/thrombotic event, we added thrombin in vitro to blood samples from 89 stable patients who had been randomly assigned to receive heparin or bivalirudin for elective PCI and examined thrombininducible platelet adhesion and aggregation under high shear conditions. Platelet adhesion increased by 10% of baseline with heparin, but decreased by 20% with bivalirudin (p=0.0047). Thrombin-inducible platelet adhesion and size of aggregates was equally inhibited by heparin and bivalirudin. Thus, under high shear conditions and excessive thrombin generation as they occur in atherosclerotic vascular compartments and acute vascular syndromes, heparin and bivalirudin inhibit thrombin-induced platelet adhesion and aggregation to a similar extent, while they have opposite effects on platelet adhesion in the absence of thrombin.

This study was part of the doctorial thesis of NR at the Department of Blood Group Serology and Transfusion Medicine.

Keywords

Bivalirudin - heparin - high shear - platelet function - thrombin

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Referenzen

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