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Type: Journal article
Title: Platelet hyperaggregability in patients with atrial fibrillation: Evidence of a background proinflammatory milieu
Author: Procter, N.
Ball, J.
Ngo, D.
Chirkov, Y.
Isenberg, J.
Hylek, E.
Stewart, S.
Horowitz, J.
Citation: Herz, 2016; 41(1):57-62
Publisher: Urban & Vogel
Issue Date: 2016
ISSN: 0340-9937
Statement of
Nathan E.K. Procter, Jocasta Ball, Doan T.M. Ngo, Yuliy Y. Chirkov, Jeffrey S. Isenberg, Elaine M. Hylek, Simon Stewart, John D. Horowitz
Abstract: Objective: Atrial fibrillation (AF) is a condition where platelet hyperaggregability is commonly present. We examined potential physiological bases for platelet hyperaggregability in a cohort of patients with acute and chronic AF. In particular, we sought to identify the impact of inflammation [myeloperoxidase (MPO) and C-reactive protein (CRP)] and impaired nitric oxide (NO) signaling. Methods: Clinical and biochemical determinants of adenosine diphosphate (ADP)-induced platelet aggregation were sought in patients (n = 106) hospitalized with AF via univariate and multivariate analysis. Results: Hyper-responsiveness of platelets to ADP was directly (r = 0.254, p < 0.01) correlated with plasma concentrations of thrombospondin-1 (TSP-1), a matricellular protein that impairs NO responses and contributes to development of oxidative stress. In turn, plasma TSP-1 concentrations were directly correlated with MPO concentrations (r = 0.221, p < 0.05), while MPO concentrations correlated with those of asymmetric dimethylarginine (ADMA, r = 0.220, p < 0.05), and its structural isomer symmetric dimethylarginine (SDMA, r = 0.192, p = 0.05). Multivariate analysis identified TSP-1 (β = 0.276, p < 0.05) concentrations, as well as female sex (β = 0.199, p < 0.05), as direct correlates of platelet aggregability, and SDMA concentrations (β = − 0.292, p < 0.05) as an inverse correlate. Conclusion: We conclude that platelet hyperaggregability, where present in the context of AF, may be engendered by impaired availability of NO, as well as via MPO-related inflammatory activation.
Keywords: Atrial fibrillation
asymmetric dimethylarginine
platelet aggregation
Rights: © Urban & Vogel 2015
DOI: 10.1007/s00059-015-4335-y
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