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Expression of Platelet Surface Receptors and Early Changes in Platelet Function in Patients with STEMI Treated with Abciximab and Clopidogrel versus Clopidogrel Alone

  • Original Research Article
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Abstract

Background

Platelets play a crucial role in the pathogenesis of acute coronary syndromes (ACS). The efficacy of antiplatelet treatment is pivotal in the success of percutaneous coronary intervention (PCI) performed in patients with ACS.

Objective

The aim of the study was to investigate the effects of clopidogrel with or without abciximab on the expression of platelet surface receptors and platelet function in patients with ST-segment elevation myocardial infarction (STEMI) undergoing PCI.

Materials and methods

Thirty patients with STEMI were included in the study. During acute primary coronary intervention, patients received aspirin (acetylsalicylic acid) and clopidogrel in a loading dose of 300mg. Clopidogrel was the only antiplatelet therapy used by nine patients (group B). Twenty-one patients (group A) received additional abciximab. Blood samples were collected and analyzed twice: before and up to 22 hours after administration of antiplatelet therapy. The platelet aggregation was established as primary platelet-related hemostasis (closure time [CT] assessed using the PFA100 system). The absolute number of platelet surface antigens as CD41a, CD42a, CD42b, CD61, and CD62P were determined by flow cytometry analysis.

Results

The study revealed a statistically significant increase in CT induced by adenosine diphosphate and adrenaline (epinephrine) +130 seconds (p < 0.0001) and +94 seconds (p < 0.0001), respectively, in group A patients post-therapy. While in group B the parameters of CT did not change after treatment. In addition, the absolute number of CD41a antigens (glycoprotein [GP] IIb/IIIa) increased significantly after treatment in group A. No significant changes were observed after treatment in the expression of CD62P (P-selectin) antigens in either treatment group. There was a significant reduction in the percentage of CD62P-positive platelets in group B after antiplatelet therapy.

Conclusions

The absolute number of GP IIb/IIIa receptors increases and platelets are not activated up to 12 hours after cessation of abciximab therapy. Treatment of STEMI patients undergoing PCI with a loading dose of clopidogrel reduces the percentage of active platelets but does not influence the CT.

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Notes

  1. The use of trade names is for product identification only and does not imply indorsement.

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Acknowledgments

This study was financially supported as a statute project of the Institute of Cardiology, Coronary Care Unit in Warsaw, Poland (study number 2.21/III/02). The authors have no conflicts of interest that are directly relevant to the content of this study.

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Authors and Affiliations

  1. Coronary Care Unit, Institute of Cardiology and Institute of Haematology and Blood Transfusion in Warsaw, ul. Alpejska 42, Warsaw, 04-628, Poland

    Anna Konopka, Justyna Spychalska, Dariusz Sitkiewicz, Ewa Zdebska, Iwona Pilichowska, Walerian Piotrowski & Janina Stepińska

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  1. Anna Konopka
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  2. Justyna Spychalska
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  3. Dariusz Sitkiewicz
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  4. Ewa Zdebska
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  5. Iwona Pilichowska
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  6. Walerian Piotrowski
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  7. Janina Stepińska
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Corresponding author

Correspondence to Anna Konopka.

Additional information

Professor Ewa Zdebska died unexpectedly on the 28th of July 2007. She was an outstanding Polish Biochemist who worked for many years at the Department of Biochemistry in the Institute of Haematology and Blood Transfusion in Warsaw, Poland. Professor Zdebska had many scientific publications to her credit. Her main research interest was the biochemistry of blood cell membranes with expertise in glycoconjugates. She was involved in the investigation of various glycolization processes of proteins, lipids, and enzymes associated with erythrocytes, leukocytes, and platelets.

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Konopka, A., Spychalska, J., Sitkiewicz, D. et al. Expression of Platelet Surface Receptors and Early Changes in Platelet Function in Patients with STEMI Treated with Abciximab and Clopidogrel versus Clopidogrel Alone. Am J Cardiovasc Drugs 7, 433–439 (2007). https://doi.org/10.2165/00129784-200707060-00006

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  • DOI: https://doi.org/10.2165/00129784-200707060-00006

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