Key result
Patients with peripheral arterial disease on dual antiplatelet therapy had significantly decreased platelet aggregation and P-selectin expression compared to healthy controls.
Why the study?
To evaluate platelet microparticle levels and P-selectin expression in patients with peripheral arterial disease receiving antiplatelet therapy.
Does dual antiplatelet therapy reduce platelet aggregation, P-selectin expression, and platelet microparticles in patients with peripheral arterial disease compared to healthy controls and COVID-19 patients?
Observational (n=49)
Does dual antiplatelet therapy reduce platelet aggregation, P-selectin expression, and platelet microparticles in patients with peripheral arterial disease compared to healthy controls and COVID-19 patients?
Light aggregometry and flow cytometry for P-selectin and platelet microparticles provide consistent results in assessing reduced platelet reactivity in PAD patients on dual antiplatelet therapy.
Reduced platelet reactivity on antiplatelet therapy in PAD is hypothesis-generating; larger trials needed to clarify microparticle role in inflammation.
BACKGROUND: High platelet reactivity leads to the progression of atherosclerosis and its complications. Activated platelets adhere to the site of endothelium damage on the vessel wall and initiate the formation of an arterial thrombus, followed by acute ischemia of the organ. Biochemical and cellular marker such as platelet microvesicles and P-selectin can be analyzed using flow cytometry, which is based on a specific antigen-antibody interaction. Patients with peripheral arterial disease are at significantly greater risk of cardiovascular and cerebrovascular complications than individuals of the same age and sex. The use of antiplatelet agents is an important part of pathogenetic therapy and prevention of cardiovascular diseases and their complications. AIM: This study was to evaluate the level of platelet microparticles and P-selectin expression in patients with peripheral arterial disease receiving antiplatelet therapy. MATERIALS AND METHODS: The study included 49 people, which included three study groups: patients with obliterating disease of the arteries of the lower extremities (n = 14) on the background of long-term use (more than 14 days) of double (75 mg clopidogrel and 100 mg Acetylsalicylic acid) antiplatelet therapy, patients with COVID-19 (n = 15), who made up the positive control group in the determination of microparticles of platelet origin, and healthy volunteers (n = 20) without signs of acute respiratory disease, without a history of cardiovascular and thromboembolic episodes, not taking antiplatelet drugs. The functional activity of platelets was assessed by two methods: using light aggregometry and analysis of P-selectin expression on platelet surface by flow cytometry. The number of platelets microparticles in blood plasma was also determined using flow cytometry. RESULTS: A significant decrease in platelet aggregation was found in patients with peripheral arterial disease taking antiplatelet agents, compared with controls by used light aggregometry. Similar changes were obtained when analyzing the expression of P-selectin on platelets. A higher percentage of platelets microparticles with the CD9+CD41+ phenotype was found in patients with severe inflammation compared with peripheral arterial disease patients treated with antiplatelet agents and compared with the healthy controls. CONCLUSIONS: Thus, our study reflects the consistency of the results of three different laboratory tests in assessing the platelets reactivity in patients with the peripheral arterial diseases taking antiplatelet drugs.
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Ермаков et al. (2023) conducted an observational in Peripheral arterial disease (n=49). Double antiplatelet therapy vs. Healthy volunteers and patients with COVID-19 was evaluated on Platelet aggregation, P-selectin expression, and platelet microparticles. Patients with peripheral arterial disease on dual antiplatelet therapy had significantly decreased platelet aggregation and P-selectin expression compared to healthy controls.
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