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Titel:

Monocyte-platelet aggregates affect local inflammation in patients with acute myocardial infarction

Dokumenttyp:
Article
Autor(en):
Kossmann, Hans; Rischpler, Christoph; Hanus, Franziska; Nekolla, Stephan G.; Kunze, Karl P.; Goetze, Katharina; Goedel, Alexander; Sager, Hendrik; Kastrati, Adnan; Sinnecker, Daniel; Kupatt, Christian; Ibrahim, Tareq; Schwaiger, Markus; Laugwitz, Karl-Ludwig; Dirschinger, Ralf J.
Abstract:
The local inflammatory response following acute myocardial infarction (AMI) is increasingly being recognized as a central factor determining infarct healing. Myocardial inflammation can be visualized in patients using fasting F-18-FDG PET/MRI. Although this novel biosignal correlateswith long-termfunctional outcome, the corresponding cellular substrate is not well understood. Here we present a retrospective analysis of 29 patients with AMI who underwent revascularization, suggesting a connection between post infarction myocardial fasting F-18-FDG uptake, monocyte platelet aggregates (MPA), and P2Y(12) inhibition. In detail, patients with high MPA percentages of CD14(high)CD16(+) and CD14(low)CD16(+) monocytes had significantly higher local F-18-FDG uptake (SUVmean) in the infarcted myocardium than patients with low MPA (p < 0.05). Furthermore, there was an association of high MPA percentage in all monocyte subpopulations with deteriorating Delta LV-EF after 6 months (p < 0.01), which was confirmed in an extended analysis with additional 29 patients without PET/MRI data available. In this analysis, administration of Ticagrelor was associated with lower MPA percentage of CD14(high) monocyte subpopulations than Clopidogrel (p < 0.01) or Prasugrel (p < 0.05). Taken together, the findings from this analysis suggest that platelet aggregability may affect monocyte extravasation into the infarcted myocardium and influence long-term functional outcome. P2Y(12) inhibition may intervene in this pathophysiologic process. Prospective studies are needed to further examine this important relationship. (c) 2019 Elsevier B.V. All rights reserved.
Zeitschriftentitel:
Int J Cardiol
Jahr:
2019
Band / Volume:
287
Seitenangaben Beitrag:
7-12
Volltext / DOI:
doi:10.1016/j.ijcard.2019.04.009
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/31003796
Print-ISSN:
0167-5273
TUM Einrichtung:
I. Medizinische Klinik und Poliklinik (Kardiologie); III. Medizinische Klinik und Poliklinik (Hämatologie / Onkologie); Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert); Klinik und Poliklinik für Nuklearmedizin
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