Key result
Nonvalvular AF is linked to ~4.3-fold higher reticulated platelets vs. controls, which decline post-PVI.
Why the study?
Reticulated platelet content is increased in nonvalvular atrial fibrillation, but the modulation of platelet content, morphology, and reticulated platelet proportion by platelet genes was unclear.
Does pulmonary veins isolation modulate platelet-predominate gene expression and reticulated platelet content in patients with nonvalvular atrial fibrillation?
Observational (n=148)
Does pulmonary veins isolation modulate platelet-predominate gene expression and reticulated platelet content in patients with nonvalvular atrial fibrillation?
Pulmonary vein isolation in nonvalvular atrial fibrillation modulates the expression of platelet-predominate genes and reduces reticulated platelet content, suggesting a direct link between AF and platelet biogenesis.
Answers are grounded in this paper and cite their sources.
Associates PVI with reduced reticulated platelets in NVAF; hypothesis-generating and should not yet change practice.
AbstractIntroductionReticulated platelet (RP) content is increased in nonvalvular atrial fibrillation (NVAF). The purpose of this study was to determine if platelet content, morphology, and RP proportion are modulated by platelet genes.Methods and resultsExpression of six platelet‐predominate genes impacting platelet formation and release, platelet count, and RP content was assessed in NVAF patients before and 3–4 months after pulmonary veins isolation (PVI) and compared to normal sinus rhythm (NSR) controls. RNA from isolated platelets was reverse‐transcribed assayed against selected genes utilizing real‐time qPCR, and expressed as mean cycle threshold (ΔCt) using beta‐2‐microglobulin as endogenous control. RP content was assessed by flow cytometry. A fourfold lower expression of CFL1 gene coding for nonmuscle cofilin (7.8 ± 0.9 vs. 5.7 ± 1.6, P < 0.001) and twofold lower expression of four other genes were associated with similar platelet counts but fourfold higher (28.7+7.0 vs. 6.7+5.4, P < 0.001) RP content (%) in 97 NVAF cases compared to 51 NSR controls. Three to 4 months after PVI, RP decreased by 28%, while CFL1 gene expression increased over twofold but TUBA4A gene expression decreased almost twofold; NFE2 and MYL6 gene expression remained unchanged.ConclusionsNVAF is associated with notable downregulation of genes directing platelet production and size but increased RP content. PVI impacts the expression of many of these genes, implying a direct relationship between atrial fibrillation and platelet biogenesis.
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Wysokiński et al. (2018) conducted an observational in Nonvalvular atrial fibrillation (n=148). Nonvalvular atrial fibrillation and pulmonary veins isolation vs. Normal sinus rhythm (NSR) was evaluated on Reticulated platelet (RP) content (%) (p=<0.001). Nonvalvular atrial fibrillation was associated with higher reticulated platelet content than controls (28.7% vs 6.7%, P<0.001), which decreased by 28% following pulmonary vein isolation.
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