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Thromb Haemost 2011; 106(03): 466-474
DOI: 10.1160/TH11-04-0226
Platelets and Blood Cells
Schattauer GmbH

Platelet reactivity is a stable and global phenomenon in aspirin-treated cardiovascular patients

Anne Zufferey
1   Division of Angiology and Haemostasis, Geneva University Hospital and Faculty of Medicine, Switzerland
2   Biomedical Proteomics Research Group, Human Protein Sciences Department, University of Geneva, Switzerland
,
Jean-Luc Reny
3   Division of General Internal Medicine, Geneva University Hospital, Switzerland
,
Christophe Combescure
4   Division of Clinical Epidemiology, Geneva University Hospital, Switzerland
,
Philippe de Moerloose
1   Division of Angiology and Haemostasis, Geneva University Hospital and Faculty of Medicine, Switzerland
,
Jean-Charles Sanchez
2   Biomedical Proteomics Research Group, Human Protein Sciences Department, University of Geneva, Switzerland
,
Pierre Fontana
1   Division of Angiology and Haemostasis, Geneva University Hospital and Faculty of Medicine, Switzerland
› Author Affiliations Financial support: This work was supported by the Swiss National Science Foundation (grant No 32003B_122387), the Swiss Heart Foundation, the Dr Henri Dubois Ferrière – Dinu Lipatti Foundation, the International Society on Thrombosis and Haemostasis (ISTH) 2007 Presidential Fund, the Clinical Research Center, University Hospitals of Geneva and Faculty of Medicine, Geneva and the Louis-Jeantet Foundation, the Ernst and Lucie Schmidheiny Foundation.
Further Information

Publication History

Received: 11 April 2011

Accepted after major revision: 13 June 2011

Publication Date:
24 November 2017 (online)

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Summary

In healthy subjects, platelet hyperreactivity is a global phenomenon – as opposed to agonist-specific – and epinephrine-induced platelet aggregation (EPA) is a reliable marker of this phenotype. Few data are available on platelet reactivity and the relationship between EPA and aggregation induced by other agonists in cardiovascular patients. It was the objective of this study to characterise platelet reactivity in stable cardiovascular patients treated with aspirin and to derive a composite index integrating several aggregation pathways, suitable for selecting patients with extreme phenotypes for further proteomics analysis. Platelet reactivity to agonists was assessed in 110 patients twice, two weeks apart. Factorial analysis was used to determine whether the results obtained with the different agonists could be summarised in a single composite index. EPA correlated with the aggregation values obtained with each of the other agonists, with correlation coefficients of 0.44 to 0.55 (p<0.001). We constructed a composite “platelet reactivity” index that included 60% of the information provided by each agonist. The results obtained at the first patient visit were consistent with those obtained at the second visit (r=0.78, p<0.01). No clinical or biological parameters correlated with the composite index. The extreme phenotypes of six selected subjects were confirmed 12 months after the second visit. In conclusion, platelet reactivity in aspirin-treated cardiovascular patients is a global phenomenon that can be summarised by a composite index based on the aggregation responses to various agonists and integrating several activation pathways. This index is not dependent on clinical or biological variables, suggesting that genetic factors regulate platelet reactivity in these patients.

Keywords

Platelet - aspirin - aggregation - atherothrombosis
 

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