Chazov National Medical Research Center of Cardiology, Moscow, Russia.
Biomed Khim. 2024 Apr;70(2):99-108. doi: 10.18097/PBMC20247002099.
Platelet functional activity was assessed in healthy volunteers (HV, n=92), patients with stable angina pectoris (SA, n=42) and acute coronary syndrome (ACS, n=73), treated with acetylsalicylic acid (ASA) + clopidogrel and ASA + ticagrelor, respectively. In all HV and patients we have compared parameters of platelet aggregation (maximum light transmission and velocity, Tmax and Vmax) and parameters, characterizing exposure of platelet activation markers, evaluated by flow cytometry. HV platelets were activated by 10 μM, 1 μM TRAP, and 20 μM, 5 μM, 2.5 μM ADP; patient platelets were activated by 10 μM TRAP and by 20 μM and 5 μM ADP. Strong and significant correlations between the aggregation and flow cytometry parameters (the r correlation coefficient from 0.4 up to >0.6) most frequently were registered in HV platelet during activation by 1 μM TRAP and in SA patients during platelet activation by 20 μM and 5 μM ADP. However, in many other cases these correlations were rather weak (r < 0.3) and sometimes statistically insignificant. In HV the differences in PAC-1 binding parameters between platelets activated by 10 μM TRAP (the strongest agonist) and all ADP concentrations were negligible (≤ 10%), while CD62P binding (at all ADP concentrations) and LTA parameters for (5 μM and 2.5 μM ADP) were significantly lower (by 40-60%). Antiplatelet therapy in patients decreased all parameters as compared to HV, but to varying extents. For 10 μM TRAP the MFI index for PAC-1 binding (40-50% decrease) and for both ADP concentrations the Tmax values (60-85% decrease) appeared to be the most sensitive in comparison with the other parameters that decreased to a lesser extent. The data obtained indicate a possibility of inconsistency between different LTA and flow cytometry parameters in assessing platelet activity and efficacy of antiplatelet drugs.
血小板功能活性在健康志愿者（HV，n=92）、稳定性心绞痛（SA，n=42）和急性冠脉综合征（ACS，n=73）患者中进行了评估，这些患者分别接受了乙酰水杨酸（ASA）+氯吡格雷和 ASA+替格瑞洛治疗。在所有 HV 和患者中，我们比较了血小板聚集（最大透光率和速度，Tmax 和 Vmax）的参数和通过流式细胞术评估的血小板活化标志物暴露的参数。HV 血小板用 10 μM、1 μM TRAP 和 20 μM、5 μM、2.5 μM ADP 激活；患者血小板用 10 μM TRAP 和 20 μM 和 5 μM ADP 激活。在 HV 血小板用 1 μM TRAP 激活和 SA 患者血小板用 20 μM 和 5 μM ADP 激活时，最常观察到聚集和流式细胞术参数之间具有强且显著的相关性（相关系数 r 从 0.4 到>0.6）。然而，在许多其他情况下，这些相关性较弱（r<0.3），有时甚至无统计学意义。在 HV 中，用 10 μM TRAP（最强激动剂）激活的血小板和所有 ADP 浓度之间的 PAC-1 结合参数的差异可忽略不计（≤10%），而 CD62P 结合（所有 ADP 浓度）和 LTA 参数（5 μM 和 2.5 μM ADP）显著降低（40-60%）。与 HV 相比，患者的抗血小板治疗降低了所有参数，但降低程度不同。与其他参数相比，用 10 μM TRAP 激活的血小板的 PAC-1 结合 MFI 指数（40-50%降低）和两种 ADP 浓度的 Tmax 值（60-85%降低）似乎更敏感。所得数据表明，在评估血小板活性和抗血小板药物的疗效时，不同的 LTA 和流式细胞术参数之间可能存在不一致性。
