In this study, we aim to assess whether remote ischemic preconditioning (RIPC) reduces
platelet activation during coronary angiography (CA) and/or percutaneous coronary
interventions. We studied 30 patients who underwent CA because of a suspect of stable
angina. Patients were randomized to RIPC (3 short episodes of forearm ischemia) or
sham RIPC (controls) before the procedure. Blood samples were collected at baseline,
at the end of the procedure, and 24 hours later. Monocyte–platelet aggregate (MPA)
formation and platelet CD41 in the MPA gate and CD41 and CD62 expression in the platelet
gate were assessed by flow cytometry, in the absence and in the presence of adenosine
diphosphate (ADP) stimulation. A significant increase in platelet activation occurred
during the invasive procedure in controls, which persisted at 24 hours. However, compared
with controls, RIPC group showed no or a lower increase in platelet variables, including
MPA formation (p <0.0001) and CD41 (p = 0.002) in the MPA gate and CD41 (p <0.0001)
and CD62 (p = 0.002) in the platelet gate. ADP increased platelet activation at baseline,
but did not further increase platelet reactivity during the invasive procedure in
either groups. Percutaneous coronary interventions, performed in 10 patients (6 in
the RIPC group and 4 in controls), did not have any further significant effect on
platelet activation and reactivity compared with CA alone. In conclusion, RIPC reduces
platelet activation occurring during CA. In contrast, no effects were observed on
platelet response to ADP stimulation, probably related to the administration of an
ADP antagonist in all patients.
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Article info
Publication history
Published online: November 17, 2015
Accepted:
October 30,
2015
Received in revised form:
October 30,
2015
Received:
September 6,
2015
Footnotes
See page 364 for disclosure information.
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Copyright
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
