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01.02.2016 | Original Article

Platelet hyperaggregability in patients with atrial fibrillation

Evidence of a background proinflammatory milieu

verfasst von: Nathan E.K. Procter, Jocasta Ball, Doan T.M. Ngo, Yuliy Y. Chirkov, Jeffrey S. Isenberg, Elaine M. Hylek, Simon Stewart, Prof. John D. Horowitz

Erschienen in: Herz | Ausgabe 1/2016

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Abstract

Objective

Atrial fibrillation (AF) is a condition where platelet hyperaggregability is commonly present. We examined potential physiological bases for platelet hyperaggregability in a cohort of patients with acute and chronic AF. In particular, we sought to identify the impact of inflammation [myeloperoxidase (MPO) and C-reactive protein (CRP)] and impaired nitric oxide (NO) signaling.

Methods

Clinical and biochemical determinants of adenosine diphosphate (ADP)-induced platelet aggregation were sought in patients (n = 106) hospitalized with AF via univariate and multivariate analysis.

Results

Hyper-responsiveness of platelets to ADP was directly (r = 0.254, p < 0.01) correlated with plasma concentrations of thrombospondin-1 (TSP-1), a matricellular protein that impairs NO responses and contributes to development of oxidative stress. In turn, plasma TSP-1 concentrations were directly correlated with MPO concentrations (r = 0.221, p < 0.05), while MPO concentrations correlated with those of asymmetric dimethylarginine (ADMA, r = 0.220, p < 0.05), and its structural isomer symmetric dimethylarginine (SDMA, r = 0.192, p = 0.05). Multivariate analysis identified TSP-1 (β = 0.276, p < 0.05) concentrations, as well as female sex (β = 0.199, p < 0.05), as direct correlates of platelet aggregability, and SDMA concentrations (β = − 0.292, p < 0.05) as an inverse correlate.

Conclusion

We conclude that platelet hyperaggregability, where present in the context of AF, may be engendered by impaired availability of NO, as well as via MPO-related inflammatory activation.

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Titel: Platelet hyperaggregability in patients with atrial fibrillation
Evidence of a background proinflammatory milieu
verfasst von: Nathan E.K. Procter
Jocasta Ball
Doan T.M. Ngo
Yuliy Y. Chirkov
Jeffrey S. Isenberg
Elaine M. Hylek
Simon Stewart
Prof. John D. Horowitz
Publikationsdatum: 01.02.2016
Verlag: Springer Medizin
Erschienen in: Herz / Ausgabe 1/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI: https://doi.org/10.1007/s00059-015-4335-y

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