Flow-Cytometric Analysis Comparing Platelet Activation during Percutaneous Transluminal Coronary Angioplasty, Stent Placement and Rotablation

Abstract

Background: Acute occlusion and subacute restenosis of the coronary artery remain the limiting factors of the otherwise successful techniques of interventional cardiology. Platelets and especially activated platelet subpopulations play a key role in these sometimes fatal complications. In this study, we used flow cytometry to compare the influences of percutaneous transluminal coronary angioplasty (PTCA, n = 12 patients), stenting (n = 8) and rotablation (n = 10) on platelet antigens and their possible alteration, indicating platelet activation. Material and Methods: Samples for flow cytometry were taken directly from the arterial sheath in free flow before the procedures, directly after the procedures, and 30 min after finishing either PTCA, stenting or rotablation. One aliquot of the sample was immediately fixed and then stabilized. Aliquots were labeled with saturating amounts of antibodies against CD41a (GPIIb-IIIa), CD42b (GPIb-V-IX), CD62p (P-selectin), CD63 (GP53), and antihuman fibrinogen, and measured within 2 h. For flow-cytometric analyses we used a FACScan cytometer. Results: CD41a and CD42b did not show significant alterations in mean channel fluorescence intensity (MCFI) before, directly after, and 30 min after finishing PTCA, stenting, or rotablation (PTCA: CD41a p = 0.8 directly after and p = 0.9 30 min after finishing; CD42b p = 0.5 and p = 0.2; stenting: CD41a p = 0.3 and p = 0.2, CD42b p = 0.5 and p = 0.7; rotablation: CD41a p = 0.2 and p = 0.2; CD42b p = 0.4 and p = 0.1). However, measuring the MCFI of CD62p, CD63, and fibrinogen binding (all p < 0.05), platelet activation could be detected directly after PTCA, stenting, or rotablation. Compared with values obtained directly after the procedures, there were further significant changes 30 min after finishing the procedures in MCFI after PTCA and stenting (CD62p, CD63, fibrinogen binding, all p < 0.05), but not after rotablation (CD62p p = 0.1; CD63 p = 0.9; fibrinogen binding p = 0.5). Conclusions: The results of our study show that all three techniques induce significant platelet activation. Activation differs between the procedures. Detecting platelet activation may help to determine patients at risk for thrombophilic adverse effects.