PTCA - PERIPROCEDURAL PLATELET ACTIVATION .2. OF THE DUESSELDORF PTCAPLATELET STUDY (DPPS)

Background Percutaneous transluminal coronary angioplasty (PTCA) with its various manipulations could create a dangerous, sudden haemostatic response. This study was performed to investigate PTCA-induced peripr ocedural changes in platelet activation and its consequences. Methods Twenty-five consecutive patients admitted for elective PTCA were precl assified as having or not having circulating activated platelets. Bloo d samples were taken for platelet activation marker analysis before, s ix times during and 2 h after PTCA. Intravascular platelet activation was analysed by flow cytometry to measure activation-dependent surface markers thrombospondin, P-selectin (CD62) and lysosomal GP53 (CD63). Results PTCA was associated with a significant seduction of peripheral platelet count. The initiation of the PTC-I procedure led to a signif icant loss of more than 50% of the degranulated, activated platelets. After PTCA, the: number of degranulated, activated platelets uniformly increased. Conclusions We conclude that PTCA can induce consumption. particularly of preactivated platelets, and lead to sustained platelet activation after the procedure. This might explain why preactivated p atients are at increased risk of suffering periprocedural ischaemic ev ents and why increased thrombogenicity favours acute flow disruption a nd the progression of coronary stenosis at the lesion site.