Association between inflammatory biomarkers and platelet aggregation in patients under chronic clopidogrel treatment.

Bernlochner, I; Steinhubl, S; Braun, S; Morath, T; Jaitner, J; Stegherr, J; Mehilli, J; von Beckerath, N; Schömig, A; Kastrati, A; Sibbing, D

doi:10.1160/TH10-05-0266

2010

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Title:: Association between inflammatory biomarkers and platelet aggregation in patients under chronic clopidogrel treatment.
Document type:: Journal Article; Article
Author(s):: Bernlochner, I; Steinhubl, S; Braun, S; Morath, T; Jaitner, J; Stegherr, J; Mehilli, J; von Beckerath, N; Schömig, A; Kastrati, A; Sibbing, D
Abstract:: Inflammatory processes in the vessel wall are associated with progression of atherosclerosis and myocardial infarction. Both high levels of C-reactive protein (CRP)and high on-clopidogrel treatment platelet reactivity (HPR) have been linked to an increased risk of ischaemic events after percutaneous coronary intervention (PCI). The aim of this study was to explore the association between biomarker levels of inflammation and platelet reactivity. Stable patients (n=1,223) eligible for this study were under chronic antiplatelet treatment with aspirin and clopidogrel due to prior coronary stent placement. ADP-induced platelet aggregation (in AU*min) was measured on a Multiplate analyser. The primary outcome measure of this retrospective study was the ADP-induced platelet aggregation in patients with versus those without elevated CRP levels. Of the patients 15.5% (n=189) showed elevated CRP levels (>=5 mg/l). Platelet aggregation (median [interquartile range]) was significantly higher in patients with elevated CRP levels compared to patients with normal (<5 mg/l) CRP levels (305 [202-504] AU*min vs. 218 [144-384] AU*min; p<0.001).A multivariable linear regression model that adjusted for known predictors of HPR confirmed a significant independent association between elevated CRP levels and high ADP-induced platelet aggregation values (p=0.0002).Elevated WBC count and fibrinogen levels were also associated with higher platelet aggregation values (p<0.001 for both). In conclusion, elevated levels of CRP, WBC count and fibrinogen were significantly associated with high platelet reactivity in patients under chronic clopidogrel treatment. Whether a direct relation between platelets and inflammation exists, as well as the clinical impact of our results, warrants further investigations.
Journal title abbreviation:: Thromb Haemost
Year:: 2010
Journal volume:: 104
Journal issue:: 6
Pages contribution:: 1193-200
Language:: eng
Fulltext / DOI:: doi:10.1160/TH10-05-0266
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/20838744
Print-ISSN:: 0340-6245
TUM Institution:: I. Medizinische Klinik und Poliklinik (Kardiologie); Institut für Laboratoriumsmedizin (keine SAP-Zuordnung!)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Klinik und Poliklinik für Innere Medizin I, Kardiologie (Prof. Laugwitz)2010

mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Institut für Laboratoriumsmedizin (DHM) (Prof. Holdenrieder)2010