American Journal of Cardiology
Volume 104, Issue 6 , Pages 764-768 , 15 September 2009

Effect of Blood Hematocrit and Erythrocyte Deformability on Adenosine 5′-Diphosphate Platelet Reactivity in Patients With Acute Coronary Syndromes on Dual Antiplatelet Therapy

  • Emanuele Cecchi, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • Fondazione Don Carlo Gnocchi Onlus, Centro IRCCS “Santa Maria agli Ulivi”, Impruneta, Florence, Italy
    • ,
  • Rossella Marcucci, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Rita Paniccia, BSc

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Brunella Bandinelli, BSc

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Serafina Valente, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Cristina Giglioli, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Chiara Lazzeri, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Gian Franco Gensini, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • Fondazione Don Carlo Gnocchi Onlus, Centro IRCCS “Santa Maria agli Ulivi”, Impruneta, Florence, Italy
    • ,
  • Rosanna Abbate, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • ,
  • Lucia Mannini, MD

      Affiliations

    • Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
    • Corresponding Author InformationCorresponding author: Tel: 39-055-7949582; fax: 39-055-7949418

Received 27 January 2009 ,Revised 2 May 2009 ,Accepted 2 May 2009.

References 

  1. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med. 2001;345:494–502
  2. Mehta SR, Yusuf S, Peters RJ, Bertrand ME, Lewis BS, Natarajan MK, et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet. 2001;358:527–533
  3. McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet. 2004;364:1519–1521
  4. Park DW, Park SW, Park KH, Lee BK, Kim YH, Lee CW, et al. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol. 2006;98:352–356
  5. Shenkman B, Matetzky S, Fefer P, Hod H, Einav Y, Lubetsky A, et al. Variable responsiveness to clopidogrel and aspirin among patients with acute coronary syndrome as assessed by platelet function tests. Thromb Res. 2008;122:336–345
  6. Snoep JD, Hovens MM, Eikenboom JC, van der Bom JG, Jukema JW, Huisman MV. Clopidogrel nonresponsiveness in patients undergoing percutaneous coronary intervention with stenting: a systematic review and meta-analysis. Am Heart J. 2007;154:221–231
  7. Nguyen TA, Diodati JG, Pharand C. Resistance to clopidogrel: a review of the evidence. J Am Coll Cardiol. 2005;45:1157–1164
  8. Geisler T, Langer H, Wydymus M, Göhring K, Zürn C, Bigalke B, et al. Low response to clopidogrel is associated with cardiovascular outcome after coronary stent implantation. Eur Heart J. 2006;27:2420–2425
  9. Buonamici P, Marcucci R, Migliorini A, Gensini GF, Santini A, Paniccia R, et al. Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis. J Am Coll Cardiol. 2007;49:2312–2317
  10. Mannini L, Marcucci R, Paniccia R, Antonucci E, Giglioli C, Valente S, et al. Erythrocyte deformability and white blood cell count are associated with aspirin resistance in high-risk vascular patients. Clin Hemorheol Microcirc. 2006;35:175–181
  11. Feher G, Koltai K, Papp E, Alkonyi B, Solyom A, Kenyeres P, et al. Aspirin resistance: possible roles of cardiovascular risk factors, previous disease history, concomitant medications and haemorrheological variables. Drugs Aging. 2006;23:559–567
  12. Voeltz MD, Patel AD, Feit F, Fazel R, Lincoff AM, Manoukian SV. Effect of anemia on hemorrhagic complications and mortality following percutaneous coronary intervention. Am J Cardiol. 2007;99:1513–1517
  13. Cecchi E, Marcucci R, Poli D, Antonucci E, Abbate R, Gensini GF, et al. Hyperviscosity as a possible risk factor for cerebral ischemic complications in atrial fibrillation patients. Am J Cardiol. 2006;97:1745–1748
  14. von Beckerath N, Kastrati A, Wieczorek A, Pogatsa-Murray G, Sibbing D, Graf I, et al. A double-blind, randomized study on platelet aggregation in patients treated with a daily dose of 150 or 75 mg of clopidogrel for 30 days. Eur Heart J. 2007;28:1814–1819
  15. Jernberg T, Payne CD, Winters KJ, Darstein C, Brandt JT, Jakubowski JA, et al. Prasugrel achieves greater inhibition of platelet aggregation and a lower rate of non-responders compared with clopidogrel in aspirin-treated patients with stable coronary artery disease. Eur Heart J. 2006;27:1166–1173
  16. Angiolillo DJ, Fernández-Ortiz A, Bernardo E, Ramírez C, Sabaté M, Bañuelos C, et al. High clopidogrel loading dose during coronary stenting: effects on drug response and interindividual variability. Eur Heart J. 2004;25:1903–1910
  17. Kobayashi S, Hamazaki T, Sawazaki S, Nakamura H. Reduction in the ADP release from shear-stressed red blood cells by fish oil administration. Thromb Res. 1992;65:353–364
  18. Ho M, Maple C, Bancroft A, McLaren M, Belch JJ. The beneficial effects of omega-3 and omega-6 essential fatty acid supplementation on red blood cell rheology. Prostaglandins Leukot Essent Fatty Acids. 1999;61:13–17
  19. Calder PC. N-3 fatty acids and cardiovascular disease: evidence explained and mechanisms explored. Clin Sci Lond. 2004;107:1–11
  20. Cavusoglu E, Chopra V, Gupta A, Clark LT, Eng C, Marmur JD. Usefulness of anemia in men as an independent predictor of two-year cardiovascular outcome in patients presenting with acute coronary syndrome. Am J Cardiol. 2006;98:580–584
  21. Lee PY, Chen WH, Ng W, Cheng X, Kwok JY, Tse HF, et al. Low-dose aspirin increases aspirin resistance in patients with coronary artery disease. Am J Med. 2005;118:723–727
  22. Kleinbongard P, Schulz R, Rassaf T, Lauer T, Dejam A, Jax T, et al. Red blood cells express a functional endothelial nitric oxide synthase. Blood. 2006;107:2943–2951
  23. Mellion BT, Ignarro LJ, Ohlstein EH, Pontecorvo EG, Hyman AL, Kadowitz PJ. Evidence for the inhibitory role of guanosine 3′,5′-monophosphate in ADP-induced human platelet aggregation in the presence of nitric oxide and related vasodilators. Blood. 1981;57:946–955
  24. Carroll JS, Ku CJ, Karunarathne W, Spence DM. Red blood cell stimulation of platelet nitric oxide production indicated by quantitative monitoring of the communication between cells in the bloodstream. Anal Chem. 2007;79:5133–5138
  25. Singla I, Zahid M, Good CB, Macioce A, Sonel AF. Impact of blood transfusions in patients presenting with anemia and suspected acute coronary syndrome. Am J Cardiol. 2007;99:1119–1121
  26. Cesari F, Marcucci R, Caporale R, Paniccia R, Romano E, Gensini GF, et al. Relationship between high platelet turnover and platelet function in high-risk patients with coronary artery disease on dual antiplatelet therapy. Thromb Haemost. 2008;99:930–935
  27. Sewell R, Ibbotson RM, Phillips R, Carson P. High mean platelet volume after myocardial infarction: is it due to consumption of small platelets?. Br Med J. 1984;289:1576–1578
  28. Zafar MU, Vilahur G, Choi BG, Ibanez B, Viles-Gonzalez JF, Salas E, et al. A novel anti-ischemic nitric oxide donor (LA419) reduces thrombogenesis in healthy human subjects. J Thromb Haemost. 2007;5:1195–1200
  29. Simó M, Santaolaria M, Murado J, Pérez ML, Corella D, Vayá A. Erythrocyte deformability in anaemic patients with reticulocytosis determined by means of ektacytometry techniques. Clin Hemorheol Microcirc. 2007;37:263–267
  30. Xie L, Jiang Y, Yao W, Gu L, Sun D, Ka W, et al. Studies on the biomechanical properties of maturing reticulocytes. J Biomech. 2006;39:530–535

 This work was supported by grants from Ente Cassa di Risparmio di Firenze to the Fiorgen Foundation, Florence, Italy.

PII: S0002-9149(09)01037-6

doi: 10.1016/j.amjcard.2009.05.005

American Journal of Cardiology
Volume 104, Issue 6 , Pages 764-768 , 15 September 2009

Article Tools

* Image Usage & Resolution