Flow-cytometric analysis of platelet activation during rotablation

Acute occlusion and subacute restenosis of the coronary artery are still th e limiting factors of the otherwise successful interventional cardiology. P latelets and especially activated platelet populations play a key role conc erning these typical and sometimes fatal complications. In this study we us ed flow-cytometry to determine the influence of the modern interventional t echnique of rotablation on platelet antigens and their possible alteration. A PTCA control group was included. We analyzed the fluorescence expression of structural antigens CD41a (GPII-IIIa) and CD42b (GPIb-V-IX), and of the activation-dependent antigens CD62p (P-selectin, PADGEM, GMP-140) and CD63 (GP53). Furthermore we analyzed the binding of fibrinogen to the platelet flow-cytometrically. CD41a and CD42b did not show significant alternations in fluorescence before, directly after and thirty minutes after finishing P TCA and rotablation (PTCA: CD41a p = 0.8 and 0.9; CD 42b p = 0.5 and 0.2; r otablation: CD41a p = 0.2 and 0.2; CD42b p = 0.4 and 0.1). But platelet act ivation could be detected directly after PTCA and rotablation measuring the mean channel fluorescence intensity (MCFI) of CD62p, CD63 and fibrinogen b inding (all p < 0.05). Thirty minutes after finishing the procedures there were again significant changes in MCFI in PTCA (CD62p, CD63, fibrinogen bin ding; all p < 0.05), but not in rotablation (CD62p p = 0.1; CD63 p = 0.9; f ibrinogen binding p = 0.5). But MCFI for CD62p and fibrinogen binding in ro tablation was higher than in PTCA. The results of our study show that rotab lation also induces significant platelet activation that is higher than in PTCA alone. Flow cytometry is a sensitive and specific, multiparametric too l in establishing platelet activation. The individual platelet activation p rocess is part of a complex cascade of events happening in the rotablated c oronary segment leading to a vascular-molecular inflammatory process and co nsecutive clinical problems in some patients.