Abstract
Recently it was shown that inflammation adversely influences results obtained from the platelet function analyzer system, PFA-100, hypothesizing that inflammation could confound interpretation of platelet function results. We investigated the clinical relevance of these results in patients with peripheral arterial occlusive disease (PAOD), with and without signs of systemic inflammation. In 98 PAOD patients, all treated with acetyl-salicylic acid (ASA), we obtained PFA-100 values upon stimulation with epinephrine. C-reactive protein (CRP) values were investigated as indicator for systemic inflammation. Mean CRP levels were elevated in 23 patients (23%). There was no difference of mean PFA-100 results between patients with elevated CRP levels and those without. Our results indicate that the effect of ASA on platelet aggregation, as measured by the PFA-100, is not relevantly influenced in PAOD patients with elevated CRP.
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Abbreviations
- PAOD :
-
Peripheral arterial occlusive disease
- PFA-100 :
-
Platelet function analyzer system-100
- ASA :
-
Acetyl-salicylic acid
- CRP :
-
C-reactive protein
- VWF :
-
Von Willebrand factor
- C/EPI-CT :
-
Collagen/epinephrine-stimulated closure time
References
Montalescot G, Collet JP, Lison L, Choussat R, Ankri A, Vicaut E et al (2000) Effects of various anticoagulant treatments on von Willebrand factor release in unstable angina. J Am Coll Cardiol 36:110–114
Fiotti N, Giansante C, Ponte E, Delbello C, Calabrese S, Zacchi T et al (1999) Atherosclerosis and inflammation. Patterns of cytokine regulation in patients with peripheral arterial disease. Atherosclerosis 145:51–60
Li-Saw-Hee FL, Blann AD, Lip GJ (2000) Effects of fixed low-dose warfarin, aspirin-warfarin combination therapy, and dose-adjusted warfarin on thrombogenesis in chronic arterial fibrillation. Stroke 31:828–833
Isaka N, Tanigawa T, Nishikawa M, Nakano T (1998) High shear stress induced platelet aggregation (h-SIPA) and effects of antiplatelet therapy. Nippon Rinsho 56:2624–2629
Homoncik M, Blann AD, Hollenstein U, Pernerstorfer T, Eichler HG, Jilma B (2000) Systemic inflammation increases shear stress-induced platelet plug formation measured by the PFA-100. Br J Haematol 111:1250–1252
Gralnik HR, McKeown LP, Wilson OM, Williams SB, Elin RJ (1989) Von Willebrand factor release induced by endotoxin. J Laborat Clin Medicine 113:118–122
Ridker PM, Stampfer MJ, Rifai N (2001) Novel risk factors for systemic atherosclerosis: a comparison of C-reactive protein, fibrinogen, homocysteine, lipoprotein(a) and standard cholesterol screening as predictors of peripheral arterial disease. JAMA 285:2481–2485
Langlois M, Duprez D, Delanghe J, Buyzere M, Clement DL (2001) Serum vitamin C concentration is low in peripheral arterial disease and is associated with inflammation and severity of atherosclerosis. Circulation 103:1863–1868
Rossi E, Biasucci LM, Citterio F, Pellicioni S, Monaco C, Ginnetti F, et al (2002) Risk of myocardial infarction and angina in patients with severe peripheral vascular disease: predictive role of C-reactive protein. Circulation 105:800–803
Ortel T, James AH, Thames EH, Moore KD, Greenberg CS (2000) Assessment of primary hemostasis by PFA-100 Analysis in a tertiatry care centre. Thromb Haemost 84:93–97
Von Pape KW, Aland E, Bohner J (2000) Platelet function analysis with PFA-100 in patients medicated with acetylsalicylic acid strongly depends on concentration of sodium citrate used for anticoagulation of blood sample. Thromb Res 98:295–299
Albert MA, Ridker PM (1999) The role of C-reactive protein in cardiovascular disease risk. Curr Cardiol Rep 1:99–104
McKenzie M, Gurbel PA, Levine DJ, Serebruany VL (1999) Clinical Utility of available methods for determining platelet function. Cardiology 92:240–247
Camici M (2002) C-reactive protein, atherosclerosis and cardiovascular disease. An update. Minerva Cardioangiol 50:327–331
Rutherford RB, Baker JD, Ernst C, Johnston KW, Porter JM, Ahn S, et al (1997) Recommended standards for reports dealing with lower extremity ischemia: revised version. J Vasc Surg 26:517–538
Homoncik M, Jilma B, Hergovich N, Stohlawetz P, Panzer S, Speiser W (2000) Monitoring of asoirin (ASA) pharmacodynamics with the platelet function analyzer PFA-100. Thromb Haemost 83:316–321
Silva JA, White CJ (2002) Plaque instability in peripheral vessels. Prog Cardiovasc Dis 44:429–436
Van Genderen PJ, van Vliet HH, Prins FJ, van de Moesdijk D, van Strik R, Zijlstra FJ, Budde U, et al (1997) Excessive prolongation of the bleeding time by aspirin in essential thrombocythemia is related to a decrease of large von Willebrand factor multimers in plasma. Ann Hematol 75:215–220
Pernerstorfer T, Eichler HG, Stohlawetz P, Speiser W, Jilma B (2001) Effects of heparin and aspirin on circulating P-selectin, E-selectin and von Willebrand Factor levels in healthy men. Atherosclerosis 155:389–393
Kaplan RC, Frishman WH (2001) Systemic inflammation as a cardiovascular disease risk factor and as a potential target for drug therapy. Heart Dis 3:326–332
Cheng TO (1999) Salutary effects of aspirin in coronary artery disease are not limited to its platelet inhibitory effects. Clin Cardiol 22:A27
Kharbanda RK, Walton B, Allen M, Klein N, Hingorani AD, et al (2002) Prevention of inflammation-induced endothelial dysfunction. A novel vasculo-protective action of aspirin. Circulation 105:2600–2604
Guarnieri G (1999) Atherosclerosis and inflammation. Patterns of cytokine regulation in patients with peripheral arterial disease. Atherosclerosis 145:51–60
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Ziegler, S., Alt, E., Brunner, M. et al. Influence of systemic inflammation on efficiency of antiplatelet therapy in PAOD patients. Ann Hematol 83, 92–94 (2004). https://doi.org/10.1007/s00277-003-0789-8
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DOI: https://doi.org/10.1007/s00277-003-0789-8