Platelets, inflammation and anti-inflammatory effects of antiplatelet drugs in ACS and CAD

Karin A. L. Müller; Madhumita Chatterjee; Dominik Rath; Tobias Geisler

doi:10.1160/TH14-11-0947

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2015; 114(03): 498-518
DOI: 10.1160/TH14-11-0947

Theme Issue Article

Schattauer GmbH

Platelets, inflammation and anti-inflammatory effects of antiplatelet drugs in ACS and CAD

Karin A. L. Müller

¹Medizinische Klinik III, Abteilung für Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen, Germany

²La Jolla Institute for Allergy and Immunology, La Jolla, California, USA

,

Madhumita Chatterjee

¹Medizinische Klinik III, Abteilung für Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen, Germany

,

Dominik Rath

¹Medizinische Klinik III, Abteilung für Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen, Germany

,

Tobias Geisler

¹Medizinische Klinik III, Abteilung für Kardiologie und Kreislauferkrankungen, Universitätsklinikum Tübingen, Tübingen, Germany

› Author Affiliations

Abstract

Summary

Platelets play a pivotal role in chronic inflammation leading to progression of atherosclerosis and acute coronary events. Recent discoveries on novel mechanisms and platelet-dependent inflammatory targets underpin the role of platelets to maintain a chronic inflammatory condition in cardiovascular disease. There is strong and clinically relevant crosslink between chronic inflammation and platelet activation. Antiplatelet therapy is a cornerstone in the prevention and treatment of acute cardiovascular events. The benefit of antiplatelet agents has mainly been attributed to their direct anti-aggregatory impact. Some anti-inflammatory off-target effects have also been described. However, it is unclear whether these effects are secondary due to inhibition of platelet activation or are caused by direct distinct mechanisms interfering with inflammatory pathways. This article will highlight novel platelet associated targets that contribute to inflammation in cardiovascular disease and elucidate mechanisms by which currently available antiplatelet agents evolve anti-inflammatory capacities, in particular by carving out the differential mechanisms directly or indirectly affecting platelet mediated inflammation. It will further illustrate the prognostic impact of antiplatelet therapies by reducing inflammatory marker release in recent cardiovascular trials.

Keywords

Antiplatelet agents - atherosclerosis - cytokines - platelet physiology - inflammation

Full Text

References

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