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January 1, 2000Scandinavian Cardiovascular Journal

Baseline Platelet Aggregation and Major Receptor Expression Predict Subsequent Activity Following Thrombolysis for Acute Myocardial Infarction

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Why the study?

Does baseline platelet function predict subsequent platelet activity at 24 hours following thrombolysis in patients with acute myocardial infarction?

Population

19 acute myocardial infarction (AMI) patients enrolled in the GUSTO-III trial

Design

Cohort

Follow-up

24 hours

Authors

DGDean J. Kereiakes Paul A. GurbelSinai Hospital

Discussion

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Implication

Baseline platelet function may identify AMI patients for intensified antiplatelet therapy post-thrombolysis; hypothesis-generating and requires prospective validation.

Key Points

  • To determine whether pre-reperfusion platelet aggregation and major surface receptor expression predict subsequent platelet activity 24 hours following thrombolysis for acute myocardial infarction.
  • Assessed platelet function using aggregometry and flow cytometry at baseline and at 24 hours post-thrombolytic therapy.
  • Analyzed linear regression correlations in 19 patients with acute myocardial infarction enrolled in the GUSTO-III trial.
  • Baseline platelet aggregation correlated significantly with 24-hour post-treatment aggregation across multiple agonists: ristocetin (r2 = 0.964), collagen (r2 = 0.568), 5 microM ADP (r2 = 0.529), 10 microM ADP (r2 = 0.445), and thrombin (r2 = 0.226).
  • Baseline platelet surface receptor expression linearly correlated with 24-hour levels for P-selectin (r = 0.817), vitronectin receptor (r2 = 0.634), PECAM-1 (r2 = 0.586), and GPIIb/IIIa (r2 = 0.337).

Structured PICO

Does baseline platelet function predict subsequent platelet activity at 24 hours following thrombolysis in patients with acute myocardial infarction?

P
Population
19 acute myocardial infarction (AMI) patients enrolled in the GUSTO-III trial
I
Intervention
Thrombolytic therapy
O
Outcome
Platelet aggregation and receptor expression at 24 hours following thrombolytic therapysurrogate

Baseline platelet characteristics can predict future platelet activity after coronary thrombolysis, which may help identify AMI patients who would benefit from more aggressive antiplatelet strategies.

Cite This Study

Dean J. Kereiakes Paul A. Gurbel (2000) studied this question.

synapsesocial.com/papers/6a72019b31a3df824329ea32https://doi.org/10.1080/14017430050142404

Topics

Dual antiplatelet therapy
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Increased baseline levels of platelet P-selectin, and platelet-endothelial cell adhesion molecule-1 in patients with acute myocardial infarction as predictors of unsuccessful thrombolysis1998 · 27 citations
  2. 2Platelet Function in Acute Myocardial Infarction Patients Compared with Controls1980 · 25 citations
  3. 3Intramyocardial platelet aggregation in patients with unstable angina suffering sudden ischemic cardiac death.1986 · 532 citations
  4. 4An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction1993 · 4,077 citations
  5. 5Depressed Platelet Status in an Elderly Patient With Hemorrhagic Stroke After Thrombolysis for Acute Myocardial Infarction1998 · 24 citations