ACTIVATION OF PLATELETS IN PLATELET-RICH PLASMA BY ROTABLATION IS SPEED-DEPENDENT AND CAN BE INHIBITED BY ABCIXIMAB (C7E3 FAB, REOPRO)

Citation
Ms. Williams et al., ACTIVATION OF PLATELETS IN PLATELET-RICH PLASMA BY ROTABLATION IS SPEED-DEPENDENT AND CAN BE INHIBITED BY ABCIXIMAB (C7E3 FAB, REOPRO), Circulation, 98(8), 1998, pp. 742-748
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Peripheal Vascular Diseas",Hematology,"Cardiac & Cardiovascular System
Journal title
ISSN journal
0009-7322
Volume
98
Issue
8
Year of publication
1998
Pages
742 - 748
Database
ISI
SICI code
0009-7322(1998)98:8<742:AOPIPP>2.0.ZU;2-R
Abstract
Background-Rotational atherectomy with the Rotablator catheter has imp roved percutaneous treatment of certain coronary atherosclerotic lesio ns, but the ''no-reflow'' phenomenon remains a serious complication. B ecause platelet activation by rotablation may contribute to the no-ref low phenomenon, we developed an in vitro system to test the effect of rotablation on platelets in the absence or presence of platelet GP IIb /IIIa receptor blockade with abciximab. Methods and Results-Platelet-r ich plasma (PRP) was prepared from 28 healthy human volunteers. PRP wa s divided into 4 samples: (1) no treatment, (2) 6D1 (anti-GP Ib), (3) c7E3 Fab (anti-GP IIb/IIIa + alpha(v)beta(3)), and (4) c7E3 Fab+6D1. S amples were pumped through a flow chamber containing a 2.5-mm burr rot ating at various speeds and then placed in an aggregometer. PRP sample s tested in the absence of antibody underwent more rapid and extensive aggregation when rotablated at 150 000 and 180 000 rpm compared with 0 rpm (P<0.001 at both speeds). Preincubation of platelets with c7E3 F ab decreased the slope of aggregation at each rotablation speed, with 98%, 79%, and 71% reductions at 70 000, 150 000, and 180 000 rpm, resp ectively (P=0.09 for 70 000 and P<0.001 for both 150 000 and 180 000 r pm). Preincubation of platelets with 6D1 did not decrease the slope of aggregation at any rotablation speed (P>0.5, P=0.99, and P=0.091 for 70 000, 150 000, and 180 000 rpm). Platelet ATP release, a marker of g ranule release and cell damage, was markedly increased at 180 000 rpm (P=0.002 compared with 0 rpm in the control group). Electron microscop y revealed extensive rotablation-induced platelet damage at 150 000 an d 180 000 rpm, and leakage of LDH confirmed platelet lysis at these sp eeds (P=0.002 and P<0.001 compared with 0 rpm). Conclusions-High-speed rotablation induces platelet activation of PRP, leading to aggregatio n; pretreating PRP with abciximab decreases the aggregation. These dat a suggest that pretreatment of patients with abciximab may decrease ro tablation-induced platelet aggregation during rotational atherectomy.