Duration of hypoxia influences platelet function due to free radical production in revascularization surgery of lower limb

Maria Kurthy, Endre Arato, Gabor Jancso, Laszlo Sinay, Zsofia Verzar, Barbara Cserepes, Janos Lantos, Sandor Ferencz, Szabolcs Bertok, Andrea Ferencz, Lajos Kollar, Elisabeth Roth

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Background: Ischemia reperfusion injury is a relevant problem in all situations, where segment(s) of the blood vessels are excluded from the circulation (due to thrombosis, embolism, balloon angioplasty, revascularization surgery, etc), and are reopened. Several aspects of these processes are well characterized, but the role of thrombocytes is hardly investigated. Objective and methods: The aim of this study was to compare the thrombocyte function and antioxidant-prooxidant status of patients with peripheral arterial disease, who underwent revascularization surgery in emergency (acute group; n=10) or electively (elective group; n=10). Similar data of 10 healthy (control group) blood donors were also considered. Blood samples were taken before and after surgery (2, 24 hours and one week). Platelet aggregation in platelet rich plasma (PRP) and in whole blood was measured using ADP (5 and 10 μm) and collagen (2 μg/ml) as inductors. Prooxidant status was characterized by the oxygen free radical production and plasma malondialdehyde (MDA) level, while antioxidant status was monitored by the measurement of reduced glutathione (GSH), total plasma thiol-groups (-SH) and the activity of superoxide dismutase (SOD). Results: The platelets aggregation was reduced in platelet rich plasma of both patient groups compared to control subjects confirming the satisfactory antiplatelet therapy in the course of the study. This difference between operated and control groups disappeared in whole blood, and a highly significant elevation of ADP and collagen in the acute group induces aggregation one week after the surgery (p<0.01). Free radical production was significantly elevated before the surgery in the acute group (p<0.01 vs. control and elective group), and showed a fourfold elevation during the one-week observation period (p<0.001 vs. its own baseline value), while in the elective group a twofold elevation appeared (p<0.05). Plasma MDA level was elevated in patient groups compared to control value at each time points of measurements. SOD activity was significantly reduced in patient groups before the surgery, compared to healthy people, and reduced further following the surgery. GSH and SH concentrations were similar in the three groups before surgery, but reduced in the early reperfusion in both patient groups (p<0.05). Conclusion: Ischemia reperfusion injury influenced thrombocyte function in the acute group in spite of the intensive antiplatelet and antiaggregating therapy, as it was observed in whole blood even after one week of surgery. The phenomenon was supposed to be the consequence of crosstalk of other component of blood with thrombocytes. These alterations had not been observed in the elective group. The serious imbalance in the antioxidant-prooxi_dant equilibrium can be in the background of the altered thrombocyte function.

Original languageEnglish
Pages (from-to)187-194
Number of pages8
Issue number6
Publication statusPublished - Jun 1 2007


  • Antioxidants
  • Free radicals
  • Ischemia reperfusion injury
  • Peripheral arterial disease
  • Platelets

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Health Professions (miscellaneous)
  • Cardiology and Cardiovascular Medicine

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    Kurthy, M., Arato, E., Jancso, G., Sinay, L., Verzar, Z., Cserepes, B., Lantos, J., Ferencz, S., Bertok, S., Ferencz, A., Kollar, L., & Roth, E. (2007). Duration of hypoxia influences platelet function due to free radical production in revascularization surgery of lower limb. Perfusion, 20(6), 187-194.