Platelet activation and high tissue factor level predict acute stent thrombosis in pig coronary arteries: Prothrombogenic response of drug-eluting or bare stent implantation within the first 24 hours

Mariann Gyöngyösi, Christoph Strehblow, Wolfgang Sperker, Akos Hevesi, Rita Garamvölgyi, Zsolt Petrási, Noemi Pavo, Péter Ferdinandy, Csaba Csonka, Tamás Csont, Christer Sylvén, Paul J. Declerck, Imre Pavo, Johann Wojta, Dietmar Glogar, Kurt Huber

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Abstract

Increased thrombogenicity of drug-eluting stents (DESs) has recently been reported.The aim of the present study was to investigate the prothrombogenic effect of DESs and Bare stents, and determine factors predictive of acute stent thrombosis (AST) in preclinical experiments using new stent design or coating. Circulating pre- and post-stenting parameters of platelet activation (mean platelet volume, MPV; platelet distribution width, platelet large cell ratio), thrombin activation (thrombin-antithrombin complex, TAT and prothrombin fragments, F1+2), tissue factor antigen (TF-ag) and -activity (TF-act) and plasminogen activator inhibitor-1 (PA1-1) were measured in 141 consecutive pigs. Stent implantations were performed after pretreatment with aspirin and clopidogrel with unfractionated heparin anticoagulation. Nineteen pigs (groups AST-DES, n=12; and AST-Bare, n=7) died mean 6.3 ± 2.9 h after stent implantation from AST. The remaining 122 control (C) pigs (groups C-DES, n=76, and C-Bare, n=46) survived the 1-month follow-up. Non-significantly elevated levels of post-stent F1+2 and TAT were measured in AST groups. Post-stenting MPV was increased significantly in the groups AST-DES and AST-Bare as compared with the groups C-DES and C-Bare (11.73 ± 1.12 and 11.6 ± 0.68 vs. 8.85 ± 0.78 and 9.04 ± 0.81 fL; p<0.001), similarly to TF-ag (189.1 ± 87.5 and 127 ± 34.9 vs. 42.5 ± 24.6 and 35.3 ± 37.6 pg/ml; p<0.001, respectively),TF-act (3.23 ± 0.95 and 2.73 ± 1.68 vs. 1.43 ± 1.12 and 1.61 ± 1.31 pM; p<0.01, respectively) and PA1-1 (99.1 ± 15.8 and 99 ± 14.7 vs. 53.4 ± 40.2 and 46.9 ± 42.4 ng/ml; p<0.01, respectively). Multi-variate analysis revealed elevated post-stenting plasma levels of TF-ag (p=0.016) and MPV (p=0.001) as independent risk factors for developing AST within the first 24 h in a porcine coronary stent model.

Original languageEnglish
Pages (from-to)202-209
Number of pages8
JournalThrombosis and Haemostasis
Volume96
Issue number2
DOIs
Publication statusPublished - Aug 1 2006

Keywords

  • Coronary circulation
  • Platelets
  • Stents
  • Thrombosis
  • Tissue factor

ASJC Scopus subject areas

  • Hematology

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    Gyöngyösi, M., Strehblow, C., Sperker, W., Hevesi, A., Garamvölgyi, R., Petrási, Z., Pavo, N., Ferdinandy, P., Csonka, C., Csont, T., Sylvén, C., Declerck, P. J., Pavo, I., Wojta, J., Glogar, D., & Huber, K. (2006). Platelet activation and high tissue factor level predict acute stent thrombosis in pig coronary arteries: Prothrombogenic response of drug-eluting or bare stent implantation within the first 24 hours. Thrombosis and Haemostasis, 96(2), 202-209. https://doi.org/10.1160/TH06-03-0178