Abstract
We hypothesized that direct thrombin inhibition could attenuate platelet activation and release of soluble CD40 ligand (sCD40L), a marker of inflammation, during percutaneous coronary intervention (PCI). To assess platelet function under flow conditions with bivalirudin versus unfractionated heparin (UFH), we employed the cone and plate(let) analyzer (CPA) assay in drug-spiked blood samples from volunteers (n = 3) in vitro, and then in PCI patients who received bivalirudin alone (n = 20), UFH alone (n = 15), and clopidogrel pretreatment plus bivalirudin (n = 15). Scanning electron microscopy was employed to image bivalirudin or UFH-treated platelets to determine whether platelet function observations had a morphologic explanation. Enzyme immunoassay was used to measure sCD40L levels in PCI patients. In vitro, bivalirudin decreased platelet surface coverage; UFH increased platelet surface coverage. In PCI patients, bivalirudin alone decreased platelet surface coverage, UFH alone increased platelet surface coverage, and clopidogrel pretreatment plus bivalirudin additively reduced platelet surface coverage. Unlike UFH, bivalirudin did not activate platelets in SEM studies. Bivalirudin alone or coupled with clopidogrel significantly reduced plasma sCD40L in PCI patients. In conclusion, our findings suggest that under flow conditions, bivalirudin alone or coupled with clopidogrel may have an antiplatelet effect versus UFH alone during PCI. These data suggest that bivalirudin and UFH may confer an anti-inflammatory effect by reducing sCD40L during PCI.
| Original language | English |
|---|---|
| Pages (from-to) | 417-424 |
| Number of pages | 8 |
| Journal | American Journal of Cardiology |
| Volume | 100 |
| Issue number | 3 |
| DOIs | |
| State | Published - Aug 1 2007 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Comparison of Platelet Function and Morphology in Patients Undergoing Percutaneous Coronary Intervention Receiving Bivalirudin Versus Unfractionated Heparin Versus Clopidogrel Pretreatment and Bivalirudin. / Anand, Sunil X.; Kim, Michael C.; Kamran, Mazullah; Sharma, Samin K.; Kini, Annapoorna S.; Fareed, Jawed; Hoppensteadt, Debra A.; Carbon, Frank; Cavusoglu, Erdal; Varon, David; Viles Gonzalez, Juan; Badimon, Juan J.; Marmur, Jonathan D.
In: American Journal of Cardiology, Vol. 100, No. 3, 01.08.2007, p. 417-424.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Comparison of Platelet Function and Morphology in Patients Undergoing Percutaneous Coronary Intervention Receiving Bivalirudin Versus Unfractionated Heparin Versus Clopidogrel Pretreatment and Bivalirudin
AU - Anand, Sunil X.
AU - Kim, Michael C.
AU - Kamran, Mazullah
AU - Sharma, Samin K.
AU - Kini, Annapoorna S.
AU - Fareed, Jawed
AU - Hoppensteadt, Debra A.
AU - Carbon, Frank
AU - Cavusoglu, Erdal
AU - Varon, David
AU - Viles Gonzalez, Juan
AU - Badimon, Juan J.
AU - Marmur, Jonathan D.
PY - 2007/8/1
Y1 - 2007/8/1
N2 - We hypothesized that direct thrombin inhibition could attenuate platelet activation and release of soluble CD40 ligand (sCD40L), a marker of inflammation, during percutaneous coronary intervention (PCI). To assess platelet function under flow conditions with bivalirudin versus unfractionated heparin (UFH), we employed the cone and plate(let) analyzer (CPA) assay in drug-spiked blood samples from volunteers (n = 3) in vitro, and then in PCI patients who received bivalirudin alone (n = 20), UFH alone (n = 15), and clopidogrel pretreatment plus bivalirudin (n = 15). Scanning electron microscopy was employed to image bivalirudin or UFH-treated platelets to determine whether platelet function observations had a morphologic explanation. Enzyme immunoassay was used to measure sCD40L levels in PCI patients. In vitro, bivalirudin decreased platelet surface coverage; UFH increased platelet surface coverage. In PCI patients, bivalirudin alone decreased platelet surface coverage, UFH alone increased platelet surface coverage, and clopidogrel pretreatment plus bivalirudin additively reduced platelet surface coverage. Unlike UFH, bivalirudin did not activate platelets in SEM studies. Bivalirudin alone or coupled with clopidogrel significantly reduced plasma sCD40L in PCI patients. In conclusion, our findings suggest that under flow conditions, bivalirudin alone or coupled with clopidogrel may have an antiplatelet effect versus UFH alone during PCI. These data suggest that bivalirudin and UFH may confer an anti-inflammatory effect by reducing sCD40L during PCI.
AB - We hypothesized that direct thrombin inhibition could attenuate platelet activation and release of soluble CD40 ligand (sCD40L), a marker of inflammation, during percutaneous coronary intervention (PCI). To assess platelet function under flow conditions with bivalirudin versus unfractionated heparin (UFH), we employed the cone and plate(let) analyzer (CPA) assay in drug-spiked blood samples from volunteers (n = 3) in vitro, and then in PCI patients who received bivalirudin alone (n = 20), UFH alone (n = 15), and clopidogrel pretreatment plus bivalirudin (n = 15). Scanning electron microscopy was employed to image bivalirudin or UFH-treated platelets to determine whether platelet function observations had a morphologic explanation. Enzyme immunoassay was used to measure sCD40L levels in PCI patients. In vitro, bivalirudin decreased platelet surface coverage; UFH increased platelet surface coverage. In PCI patients, bivalirudin alone decreased platelet surface coverage, UFH alone increased platelet surface coverage, and clopidogrel pretreatment plus bivalirudin additively reduced platelet surface coverage. Unlike UFH, bivalirudin did not activate platelets in SEM studies. Bivalirudin alone or coupled with clopidogrel significantly reduced plasma sCD40L in PCI patients. In conclusion, our findings suggest that under flow conditions, bivalirudin alone or coupled with clopidogrel may have an antiplatelet effect versus UFH alone during PCI. These data suggest that bivalirudin and UFH may confer an anti-inflammatory effect by reducing sCD40L during PCI.
UR - http://www.scopus.com/inward/record.url?scp=34447645830&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=34447645830&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2007.02.106
DO - 10.1016/j.amjcard.2007.02.106
M3 - Article
C2 - 17659921
AN - SCOPUS:34447645830
VL - 100
SP - 417
EP - 424
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 3
ER -