Chazov National Medical Research Center of Cardiology, Russian Ministry of Health, 15a, Academician Chazov Str., Moscow 121552, Russia.
Cells. 2024 Oct 16;13(20):1712. doi: 10.3390/cells13201712.
Increased platelet activity is a risk factor of thrombotic events in cardiovascular patients. We studied the relationship between platelet function, platelet size, and the content of reticulated platelets (RP) in patients with coronary heart disease (CHD, n = 55) and acute coronary syndrome (ACS, n = 95) receiving acetylsalicylic acid + clopidogrel or ticagrelor, respectively. The control group consisted of patients with risk factors for CHD, but with no CHD/ACS and free of antiplatelet drugs (n = 66). Platelet function was evaluated by the exposure of activated glycoprotein (GP) IIb-IIIa and P-selectin. In the control group, platelets were activated by TRAP (Thrombin Receptor Activating Peptide) 10 µM, and ADP 20, 5, 2.5 µM, and in the CHD/ACS groups, by TRAP 10 µM, and ADP 20 5 µM (±epinephrine 20 µM). Platelet size was assessed by the mean volume, % large forms, and forward scattering. RP were stained by thiazole orange. In the control group, activated GP IIb-IIIa and P-selectin correlated with platelet size and RP content after platelet activation by all agonists. Despite the decrease in platelet activity by antiplatelet drugs, most correlations (primarily for activated GP IIb-IIIa) were preserved in the CHD/ACS patients. In conclusion, increased platelet size and RP content are associated with increased platelet activity and the reduced efficacy of antiplatelet therapy.
血小板活性增加是心血管疾病患者血栓事件的危险因素。我们研究了冠心病（CHD，n=55）和急性冠脉综合征（ACS，n=95）患者的血小板功能、血小板大小与网织血小板（RP）含量之间的关系，这些患者分别接受了乙酰水杨酸+氯吡格雷或替格瑞洛治疗。对照组由存在 CHD 危险因素但无 CHD/ACS 且未使用抗血小板药物的患者组成（n=66）。通过激活糖蛋白（GP）IIb-IIIa 和 P-选择素来评估血小板功能。在对照组中，用 10µM 的血栓素受体激活肽（TRAP）和 20、5、2.5µM 的 ADP 激活血小板，在 CHD/ACS 组中，用 10µM 的 TRAP 和 5µM 的 ADP （±20µM 的肾上腺素）激活血小板。通过平均体积、大体积百分比和前向散射来评估血小板大小。用噻唑橙染色 RP。在对照组中，所有激动剂激活血小板后，激活的 GP IIb-IIIa 和 P-选择素与血小板大小和 RP 含量相关。尽管抗血小板药物降低了血小板活性，但大多数相关性（主要是激活的 GP IIb-IIIa）在 CHD/ACS 患者中仍得以保留。总之，血小板体积增大和 RP 含量增加与血小板活性增加以及抗血小板治疗效果降低有关。
