Circulating Platelet-Derived Microparticles Are Associated With Atherothrombotic Events
2006; Lippincott Williams & Wilkins; Volume: 27; Issue: 1 Linguagem: Inglês
10.1161/01.atv.0000252064.97632.2c
ISSN1524-4636
AutoresMasashi Namba, Atsushi Tanaka, Kenei Shimada, Yasushi Ozeki, Shigeru Uehata, Tsunemori Sakamoto, Yukio Nishida, Shosaku� Nomura, Junichi Yoshikawa,
Tópico(s)Coronary Interventions and Diagnostics
ResumoHomeArteriosclerosis, Thrombosis, and Vascular BiologyVol. 27, No. 1Circulating Platelet-Derived Microparticles Are Associated With Atherothrombotic Events Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toSupplementary MaterialsFree AccessLetterPDF/EPUBCirculating Platelet-Derived Microparticles Are Associated With Atherothrombotic Events Masashi Namba, Atsushi Tanaka, Kenei Shimada, Yasushi Ozeki, Shigeru Uehata, Tsunemori Sakamoto, Yukio Nishida, Shosaku Nomura and Junichi Yoshikawa Masashi NambaMasashi Namba From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Atsushi TanakaAtsushi Tanaka From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Kenei ShimadaKenei Shimada From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Yasushi OzekiYasushi Ozeki From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Shigeru UehataShigeru Uehata From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Tsunemori SakamotoTsunemori Sakamoto From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Yukio NishidaYukio Nishida From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. , Shosaku NomuraShosaku Nomura From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. and Junichi YoshikawaJunichi Yoshikawa From the Department of Cardiology (M.N., A.T., T.S., Y.N.), Baba Memorial Hospital, Sakai, Japan; the Osaka Ekisaikai Hospital (K.S., J.Y.), Osaka, Japan; Otsuka Phamaceutical Co Ltd (Y.O., S.U.), Japan; and Kishiwada City Hospital (S.N.), Kishiwada, Japan. Originally published1 Jan 2007https://doi.org/10.1161/01.ATV.0000252064.97632.2cArteriosclerosis, Thrombosis, and Vascular Biology. 2007;27:255–256A Marker for Vulnerable BloodPlatelet-derived microparticles (PDMP) are first observed as vesicles released from platelets after adhesion to vessels walls.1–3 Circulating PDMP can therefore be thought of as a marker of in vivo platelet activity.4 In these studies, flow-cytometory was applied to measure PDMP. As a result, the clinical significance of PDMP remains unresolved. In this study, we investigate the usefulness of PDMP that could vary the vulnerability for thrombotic events using newly developed ELISA kit.5Our population consisted of 66 ACS patients with or without ST segment elevation (the ACS group) and 126 patients with stable angina (the SAP group). A further 26 noncardiac chest-pain syndrome patients were selected as a control group.Circulating PDMP levels were assayed using the ELISA method5 (supplement I, available online at http://atvb.ahajournals.org). Single vessel diseased patients with first ACS (n=24) were selected for intravascular ultrasound (IVUS) analysis. Clinical follow-up was obtained for 189 (98%) patients. Mean clinical follow-up period was 11.1±2.4 months. The primary end point was major atherothrombotic events defined as sudden death of unknown etiology, recurrent or new onset of ACS, cerebral infarction, and arterial thrombosis. Results were expressed as mean value±SD or numbers (%). Statistical analysis was done with commercially available software (StatView, Abacus Concepts) (supplement II). There were no significant differences in terms of age, gender, or classical coronary risk factors among three groups (supplement III). ACS group patients had higher PDMP levels than their SAP and control counterparts (ACS 33.8±56.9 U/mL, SAP 10.8±8.0 U/mL, control 5.9±3.6 U/mL, P<0.01; supplement IV). The total arc of calcification at the culprit lesion correlated positively with circulating PDMP level (supplement V). After discharge, there were 2 (0.9%) deaths, 8 (3.6%) ACS, 3 (1%) cerebral infarctions, and 3 (1%) arterial thromboses. A multivariate logistic regression model demonstrated that high PDMP levels were an independent predictor for secondary thrombotic events (supplement VI). Kaplan–Meier curves showed that patients with high PDMP levels at discharge were associated with poorer clinical outcomes at one year (P<0.01, Figure). Download figureDownload PowerPointEvent-free survival curve for secondary atherothrombotic events. The Kaplan–Meier curve shows that patients with high PDMP levels are associated with poorer clinical outcomes at one year (P<0.01). A cut off point of 20 U/mL is used as the upper limit of the normal range in this commercially available ELISA kit.ACS is mainly caused by plaque rupture with occlusive thrombosis.6 However, Virmani et al also have reported that nonruptured plaques exist in culprit lesions in ACS, and nodular calcification usually accompanies a luminal thrombus in such cases.7 When endothelial damage occurs at an atherosclerotic plaque as a result of plaque rupture, erosion, or spontaneously occurs in calcified plaques, the exposed vessel-wall tissue factor forms a catalytic complex with circulating Factor VII and Factor VIIa, thereby initiating coagulation. Although platelet deposition is restricted by circulating blood, already-activated platelets with PDMP released by high shear stress crossing though the calcified atherosclerotic plaque8–10 provide a new prothrombotic interface for a growing thrombus, fibrin, and circulating blood.11,12 This results in the growth of the thrombus and a narrowing of the vessel. Increases in shear stress, associated with vessel narrowing, favor this process by further promoting new platelet activation and PDMP release. Ultimately, an occlusive thrombus forms and patients suffer catastrophic events with or without plaque rupture. A recent manuscript proposed the new term "vulnerable blood", high blood coagulability, to prevent clinical events for vulnerable patients as well as plaque disruptions.6 We consider that high PDMP levels reflect "vulnerable blood" status and may be of use for differentiating patients who will develop atherothrombotic events from patients who will develop a stable status.Study LimitationsThis ELISA kit cannot discriminate between particles of different sizes. There is a possibility therefore that this ELISA method may count fragmentary membrane as platelets or that PDMP aggregation may result in an underestimation of the PDMP count.DisclosuresNone.FootnotesCorrespondence to Dr Atsushi Tanaka, Department of Cardiology, Baba Memorial Hospital, 4-244, Hamadera-funao-cho Higashi, Sakai, 592-8555 Japan. E-mail [email protected] References 1 Sims PJ, Wiedmer T, Esmon CT, Weiss HJ, Shattil SJ. Assembly of the platelet prothrombinase complex is linked to vesiculation of the platelet plasma membrane. Studies in Scott syndrome: an isolated defect in platelet procoagulant activity. J Biol Chem. 1989; 264: 17049–17057.CrossrefMedlineGoogle Scholar2 Wolf P. The nature and significance of platelet products in human plasma. Br J Haematol. 1967; 13: 269–288.CrossrefMedlineGoogle Scholar3 Warren BA, Vales O. The release of vesicles from platelets following adhesion to vessel walls in vitro. Br J Exp Pathol. 1972; 53: 206–215.MedlineGoogle Scholar4 Nomura S. Function and clinical significance of platelet-derived microparticles. Int J Hematol. 2001; 74: 397–404.CrossrefMedlineGoogle Scholar5 Osumi K, Ozeki Y, Saito S, Nagamura Y, Ito H, Kimura Y, Ogura H, Nomura S. Development and assessment of enzyme immunoassay for platelet-derived microparticles. Thromb Haemost. 2001; 85: 326–330.CrossrefMedlineGoogle Scholar6 Naghavi M, Libby P, Falk E, Casscells SW, Litovsky S, Rumberger J, Badimon JJ, Stefanadis C, Moreno P, Pasterkamp G, Fayad Z, Stone PH, Waxman S, Raggi P, Madjid M, Zarrabi A, Burke A, Yuan C, Fitzgerald PJ, Siscovick DS, de Korte CL, Aikawa M, Juhani Airaksinen KE, Assmann G, Becker CR, Chesebro JH, Farb A, Galis ZS, Jackson C, Jang IK, Koenig W, Lodder RA, March K, Demirovic J, Navab M, Priori SG, Rekhter MD, Bahr R, Grundy SM, Mehran R, Colombo A, Boerwinkle E, Ballantyne C, Insull W Jr., Schwartz RS, Vogel R, Serruys PW, Hansson GK, Faxon DP, Kaul S, Drexler H, Greenland P, Muller JE, Virmani R, Ridker PM, Zipes DP, Shah PK, Willerson JT. From vulnerable plaque to vulnerable patient: a call for new definitions and risk assessment strategies: Part I. Circulation. 2003; 108: 1664–1672.LinkGoogle Scholar7 Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death: a comprehensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol. 2000; 20: 1262–1275.CrossrefMedlineGoogle Scholar8 Tang D, Yang C, Kobayashi S, Zheng J, Vito RP. Effect of stenosis asymmetry on blood flow and artery compression: a three-dimensional fluid-structure interaction model. Ann Biomed Eng. 2003; 31: 1182–1193.CrossrefMedlineGoogle Scholar9 Miyazaki Y, Nomura S, Miyake T, Kagawa H, Kitada C, Taniguchi H, Komiyama Y, Fujimura Y, Ikeda Y, Fukuhara S. High shear stress can initiate both platelet aggregation and shedding of procoagulant containing microparticles. Blood. 1996; 88: 3456–3464.CrossrefMedlineGoogle Scholar10 Holme PA, Orvim U, Hamers MJ, Solum NO, Brosstad FR, Barstad RM, Sakariassen KS. Shear-induced platelet activation and platelet microparticle formation at blood flow conditions as in arteries with a severe stenosis. Arterioscler Thromb Vasc Biol. 1997; 17: 646–653.CrossrefMedlineGoogle Scholar11 Chow TW, Hellums JD, Thiagarajan P. Thrombin receptor activating peptide (SFLLRN) potentiates shear-induced platelet microvesiculation. J Lab Clin Med. 2000; 135: 66–72.CrossrefMedlineGoogle Scholar12 Siljander P, Carpen O, Lassila R. Platelet-derived microparticles associate with fibrin during thrombosis. Blood. 1996; 87: 4651–4663.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Suades R, Padró T, Vilahur G and Badimon L (2022) Platelet-released extracellular vesicles: the effects of thrombin activation, Cellular and Molecular Life Sciences, 10.1007/s00018-022-04222-4, 79:3, Online publication date: 1-Mar-2022. 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