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ȣ - 530751 2 |
| The Level of Microparticles with Procoagulant Potential in Patients with Acute Myocardial Infarction Before and After Coronary Intervention |
| 연세의대 강남세브란스병원 심장내과¹ , (주)바이오버드² , CHA 의과학대학교 의생명과학과³ |
| 민필기¹, 이성주¹ , 박종관¹ , 홍성유² , 김종윤¹ , 이병권¹ , 홍범기¹ , 임세중¹ , 정광회³ , 권혁문¹ |
Backgrounds
Recently, it has been reported that high levels of procoagulant microparticles (MPs) are present in the circulating blood of patients with acute myocardial infarction (AMI). However, no data were collected on the level of MPs at the site of the culprit plaque in AMI. We hypothesized that culprit coronary arteries of AMI contains an elevated level of MPs with procoagulant potential and percutaneous coronary intervention (PCI) with intracoronary aspiration may reduce the level of MPs.
Methods
Patients with ST elevation MI who underwent primary PCI were enrolled in this study. Patients who underwent coronary angiography with non-cardiac disease were enrolled as controls. Blood sample from the femoral artery was obtained prior to PCI, and at the end of PCI. A blood sample of aspirate from the culprit coronary arteries was performed using the Export aspiration catheter before and after PCI. In control group, only peripheral blood from the femoral artery was obtained after angiography. MPs were isolated by capture with annexin A5 and determined their procoagulant potential with a prothrombinase assay using commercial kit. The cell origins of MPs were determined by antigenic capture with specific antibodies.
Results
We studied 21 patients with AMI (17 men, age 60 ± 15) and 16 control patients (9 men, age 62 ± 10) in this study. Baseline MPs with procoagulant potential in patients with AMI were higher than in control group (16.1 ± 18.1 vs. 3.9 ± 5.7 nmol phosphatidylserine (PS) equivalent, P=0.008). MPs of platelet origin were significantly elevated in patients with AMI compared with control group (P=0.010). The level of procoagulant MPs did not differ significantly between culprit coronary artery and peripheral artery. However, pre-intervention MPs from peripheral artery were significantly reduced after PCI (16.1 ± 18.1 vs. 10.6 ± 16.6 nmol PS equivalent, P=0.005).
Conclusion
The level of procoagulant MPs did not differ significantly between culprit coronary artery and peripheral artery. However, high levels of procoagulant platelet MPs are present in the circulating blood of patients with AMI. The elevated level of procoagulant MPs in AMI patients was successfully reduced after coronary intervention.
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