Platelet aggregation and response to aspirin therapy in cardiac allograft vasculopathy
Long-term survival after heart transplantation (HTx) is compromised by cardiac allograft vasculopathy (CAV) characterized by coronary macro- and microvascular disease. The pathogenesis of CAV is unclear and may involve coronary thrombosis. We investigated whether HTx patients with CAV had higher pla...
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| Veröffentlicht in: | The Journal of heart and lung transplantation 2020-04, Vol.39 (4), p.371-378 |
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| creator | Bjerre, Kamilla P. Clemmensen, Tor S. Berg, Katrine Poulsen, Steen H. Hvas, Anne-Mette Grove, Erik L. Løgstrup, Brian B. Jakobsen, Lars Thim, Troels Kristensen, Steen D. Eiskjær, Hans |
| description | Long-term survival after heart transplantation (HTx) is compromised by cardiac allograft vasculopathy (CAV) characterized by coronary macro- and microvascular disease. The pathogenesis of CAV is unclear and may involve coronary thrombosis. We investigated whether HTx patients with CAV had higher platelet aggregation and turnover than HTx patients without CAV and healthy controls. Furthermore, we investigated the anti-platelet effect of low-dose aspirin in HTx patients.
We included 57 patients who had undergone HTx (median 8.3 years from HTx) and 57 healthy controls. Platelet aggregation was measured on-aspirin and off-aspirin using impedance aggregometry with adenosine diphosphate (ADP) and arachidonic acid (AA). We evaluated platelet turnover by flow cytometry, CAV burden by coronary angiography and echocardiography, and microvascular function by echocardiographic coronary flow velocity reserve (CFVR).
Off-aspirin, HTx patients with CAV (n = 21) had higher ADP-induced platelet aggregation than healthy controls (p < 0.01) and HTx patients without CAV (n = 36) (p < 0.05). Aspirin treatment reduced AA-induced platelet aggregation in both HTx groups, but HTx patients with CAV had higher platelet aggregation on-aspirin than HTx patients without CAV (p < 0.05). Platelet turnover did not differ between HTx patients with CAV and HTx patients without CAV (p > 0.34). HTx patients with lower CFVR values had higher platelet aggregation than HTx patients with higher CFVR values (p < 0.05).
Off-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV and healthy controls. On-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV. Aspirin monotherapy may not provide sufficient platelet inhibition in HTx patients with CAV. |
| doi_str_mv | 10.1016/j.healun.2020.01.1344 |
| format | Article |
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We included 57 patients who had undergone HTx (median 8.3 years from HTx) and 57 healthy controls. Platelet aggregation was measured on-aspirin and off-aspirin using impedance aggregometry with adenosine diphosphate (ADP) and arachidonic acid (AA). We evaluated platelet turnover by flow cytometry, CAV burden by coronary angiography and echocardiography, and microvascular function by echocardiographic coronary flow velocity reserve (CFVR).
Off-aspirin, HTx patients with CAV (n = 21) had higher ADP-induced platelet aggregation than healthy controls (p < 0.01) and HTx patients without CAV (n = 36) (p < 0.05). Aspirin treatment reduced AA-induced platelet aggregation in both HTx groups, but HTx patients with CAV had higher platelet aggregation on-aspirin than HTx patients without CAV (p < 0.05). Platelet turnover did not differ between HTx patients with CAV and HTx patients without CAV (p > 0.34). HTx patients with lower CFVR values had higher platelet aggregation than HTx patients with higher CFVR values (p < 0.05).
Off-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV and healthy controls. On-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV. Aspirin monotherapy may not provide sufficient platelet inhibition in HTx patients with CAV.</description><identifier>ISSN: 1053-2498</identifier><identifier>EISSN: 1557-3117</identifier><identifier>DOI: 10.1016/j.healun.2020.01.1344</identifier><identifier>PMID: 32067865</identifier><language>eng</language><publisher>NEW YORK: Elsevier Inc</publisher><subject>Aged ; Allografts ; aspirin ; Aspirin - therapeutic use ; Cardiac & Cardiovascular Systems ; cardiac allograft vasculopathy ; Cardiovascular System & Cardiology ; Coronary Angiography ; coronary artery disease ; Cross-Sectional Studies ; Denmark - epidemiology ; Female ; Follow-Up Studies ; Graft Rejection - diagnosis ; Graft Rejection - drug therapy ; Graft Rejection - mortality ; heart transplantation ; Heart Transplantation - adverse effects ; Humans ; Life Sciences & Biomedicine ; Male ; Middle Aged ; Platelet Aggregation - drug effects ; Platelet Aggregation Inhibitors - therapeutic use ; Respiratory System ; Retrospective Studies ; Science & Technology ; Surgery ; Survival Rate - trends ; Time Factors ; Transplantation ; treatment</subject><ispartof>The Journal of heart and lung transplantation, 2020-04, Vol.39 (4), p.371-378</ispartof><rights>2020 International Society for Heart and Lung Transplantation</rights><rights>Copyright © 2020 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>true</woscitedreferencessubscribed><woscitedreferencescount>14</woscitedreferencescount><woscitedreferencesoriginalsourcerecordid>wos000520854600010</woscitedreferencesoriginalsourcerecordid><citedby>FETCH-LOGICAL-c365t-9b6fe9b418ac7c698e4fb5bd94cdcf14306c9088814b1304dcfeb24bb6cc48f03</citedby><cites>FETCH-LOGICAL-c365t-9b6fe9b418ac7c698e4fb5bd94cdcf14306c9088814b1304dcfeb24bb6cc48f03</cites><orcidid>0000-0002-1466-0865 ; 0000-0003-1520-1924 ; 0000-0002-2522-9253 ; 0000-0001-9309-4701 ; 0000-0001-9043-8898</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.healun.2020.01.1344$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,28253,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32067865$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bjerre, Kamilla P.</creatorcontrib><creatorcontrib>Clemmensen, Tor S.</creatorcontrib><creatorcontrib>Berg, Katrine</creatorcontrib><creatorcontrib>Poulsen, Steen H.</creatorcontrib><creatorcontrib>Hvas, Anne-Mette</creatorcontrib><creatorcontrib>Grove, Erik L.</creatorcontrib><creatorcontrib>Løgstrup, Brian B.</creatorcontrib><creatorcontrib>Jakobsen, Lars</creatorcontrib><creatorcontrib>Thim, Troels</creatorcontrib><creatorcontrib>Kristensen, Steen D.</creatorcontrib><creatorcontrib>Eiskjær, Hans</creatorcontrib><title>Platelet aggregation and response to aspirin therapy in cardiac allograft vasculopathy</title><title>The Journal of heart and lung transplantation</title><addtitle>J HEART LUNG TRANSPL</addtitle><addtitle>J Heart Lung Transplant</addtitle><description>Long-term survival after heart transplantation (HTx) is compromised by cardiac allograft vasculopathy (CAV) characterized by coronary macro- and microvascular disease. The pathogenesis of CAV is unclear and may involve coronary thrombosis. We investigated whether HTx patients with CAV had higher platelet aggregation and turnover than HTx patients without CAV and healthy controls. Furthermore, we investigated the anti-platelet effect of low-dose aspirin in HTx patients.
We included 57 patients who had undergone HTx (median 8.3 years from HTx) and 57 healthy controls. Platelet aggregation was measured on-aspirin and off-aspirin using impedance aggregometry with adenosine diphosphate (ADP) and arachidonic acid (AA). We evaluated platelet turnover by flow cytometry, CAV burden by coronary angiography and echocardiography, and microvascular function by echocardiographic coronary flow velocity reserve (CFVR).
Off-aspirin, HTx patients with CAV (n = 21) had higher ADP-induced platelet aggregation than healthy controls (p < 0.01) and HTx patients without CAV (n = 36) (p < 0.05). Aspirin treatment reduced AA-induced platelet aggregation in both HTx groups, but HTx patients with CAV had higher platelet aggregation on-aspirin than HTx patients without CAV (p < 0.05). Platelet turnover did not differ between HTx patients with CAV and HTx patients without CAV (p > 0.34). HTx patients with lower CFVR values had higher platelet aggregation than HTx patients with higher CFVR values (p < 0.05).
Off-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV and healthy controls. On-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV. Aspirin monotherapy may not provide sufficient platelet inhibition in HTx patients with CAV.</description><subject>Aged</subject><subject>Allografts</subject><subject>aspirin</subject><subject>Aspirin - therapeutic use</subject><subject>Cardiac & Cardiovascular Systems</subject><subject>cardiac allograft vasculopathy</subject><subject>Cardiovascular System & Cardiology</subject><subject>Coronary Angiography</subject><subject>coronary artery disease</subject><subject>Cross-Sectional Studies</subject><subject>Denmark - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Graft Rejection - diagnosis</subject><subject>Graft Rejection - drug therapy</subject><subject>Graft Rejection - mortality</subject><subject>heart transplantation</subject><subject>Heart Transplantation - adverse effects</subject><subject>Humans</subject><subject>Life Sciences & Biomedicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Aggregation - drug effects</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Respiratory System</subject><subject>Retrospective Studies</subject><subject>Science & Technology</subject><subject>Surgery</subject><subject>Survival Rate - trends</subject><subject>Time Factors</subject><subject>Transplantation</subject><subject>treatment</subject><issn>1053-2498</issn><issn>1557-3117</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AOWDO</sourceid><sourceid>EIF</sourceid><recordid>eNqNkU-P1CAYhxvjxl1XP4KGo8mmXSh_Sk_GTHbVZBM9qFcC9O0ME6ZUoGvm28vYca964hfy_ID3oareENwQTMTtvtmB9svUtLjFDSYNoYw9q64I511NCemel4w5rVvWy8vqZUp7jHFLefuiuqQtFp0U_Kr68dXrDB4y0ttthK3OLkxITwOKkOYwJUA5IJ1mF92E8g6ino-oRKvj4LRF2vuwjXrM6FEnu_gw67w7vqouRu0TvD6v19X3-7tvm0_1w5ePnzcfHmpLBc91b8QIvWFEattZ0Utgo-Fm6Jkd7EgYxcL2WEpJmCEUs7IJpmXGCGuZHDG9rt6t584x_FwgZXVwyYL3eoKwJFXm7VhHMCUF5StqY0gpwqjm6A46HhXB6qRU7dWqVJ2UKkzUSWnpvT1fsZgDDE-tvw4LcLMCv8CEMVkHk4UnrEjnLZaciZLI6cXy_-mNy38-ZBOWKZfq-7UKxeijg6jO9cFFsFkNwf1jlt9yGKwK</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Bjerre, Kamilla P.</creator><creator>Clemmensen, Tor S.</creator><creator>Berg, Katrine</creator><creator>Poulsen, Steen H.</creator><creator>Hvas, Anne-Mette</creator><creator>Grove, Erik L.</creator><creator>Løgstrup, Brian B.</creator><creator>Jakobsen, Lars</creator><creator>Thim, Troels</creator><creator>Kristensen, Steen D.</creator><creator>Eiskjær, Hans</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>AOWDO</scope><scope>BLEPL</scope><scope>DTL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-1466-0865</orcidid><orcidid>https://orcid.org/0000-0003-1520-1924</orcidid><orcidid>https://orcid.org/0000-0002-2522-9253</orcidid><orcidid>https://orcid.org/0000-0001-9309-4701</orcidid><orcidid>https://orcid.org/0000-0001-9043-8898</orcidid></search><sort><creationdate>202004</creationdate><title>Platelet aggregation and response to aspirin therapy in cardiac allograft vasculopathy</title><author>Bjerre, Kamilla P. ; Clemmensen, Tor S. ; Berg, Katrine ; Poulsen, Steen H. ; Hvas, Anne-Mette ; Grove, Erik L. ; Løgstrup, Brian B. ; Jakobsen, Lars ; Thim, Troels ; Kristensen, Steen D. ; Eiskjær, Hans</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c365t-9b6fe9b418ac7c698e4fb5bd94cdcf14306c9088814b1304dcfeb24bb6cc48f03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged</topic><topic>Allografts</topic><topic>aspirin</topic><topic>Aspirin - therapeutic use</topic><topic>Cardiac & Cardiovascular Systems</topic><topic>cardiac allograft vasculopathy</topic><topic>Cardiovascular System & Cardiology</topic><topic>Coronary Angiography</topic><topic>coronary artery disease</topic><topic>Cross-Sectional Studies</topic><topic>Denmark - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Graft Rejection - diagnosis</topic><topic>Graft Rejection - drug therapy</topic><topic>Graft Rejection - mortality</topic><topic>heart transplantation</topic><topic>Heart Transplantation - adverse effects</topic><topic>Humans</topic><topic>Life Sciences & Biomedicine</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Aggregation - drug effects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Respiratory System</topic><topic>Retrospective Studies</topic><topic>Science & Technology</topic><topic>Surgery</topic><topic>Survival Rate - trends</topic><topic>Time Factors</topic><topic>Transplantation</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bjerre, Kamilla P.</creatorcontrib><creatorcontrib>Clemmensen, Tor S.</creatorcontrib><creatorcontrib>Berg, Katrine</creatorcontrib><creatorcontrib>Poulsen, Steen H.</creatorcontrib><creatorcontrib>Hvas, Anne-Mette</creatorcontrib><creatorcontrib>Grove, Erik L.</creatorcontrib><creatorcontrib>Løgstrup, Brian B.</creatorcontrib><creatorcontrib>Jakobsen, Lars</creatorcontrib><creatorcontrib>Thim, Troels</creatorcontrib><creatorcontrib>Kristensen, Steen D.</creatorcontrib><creatorcontrib>Eiskjær, Hans</creatorcontrib><collection>Web of Science - Science Citation Index Expanded - 2020</collection><collection>Web of Science Core Collection</collection><collection>Science Citation Index Expanded</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of heart and lung transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bjerre, Kamilla P.</au><au>Clemmensen, Tor S.</au><au>Berg, Katrine</au><au>Poulsen, Steen H.</au><au>Hvas, Anne-Mette</au><au>Grove, Erik L.</au><au>Løgstrup, Brian B.</au><au>Jakobsen, Lars</au><au>Thim, Troels</au><au>Kristensen, Steen D.</au><au>Eiskjær, Hans</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Platelet aggregation and response to aspirin therapy in cardiac allograft vasculopathy</atitle><jtitle>The Journal of heart and lung transplantation</jtitle><stitle>J HEART LUNG TRANSPL</stitle><addtitle>J Heart Lung Transplant</addtitle><date>2020-04</date><risdate>2020</risdate><volume>39</volume><issue>4</issue><spage>371</spage><epage>378</epage><pages>371-378</pages><issn>1053-2498</issn><eissn>1557-3117</eissn><abstract>Long-term survival after heart transplantation (HTx) is compromised by cardiac allograft vasculopathy (CAV) characterized by coronary macro- and microvascular disease. The pathogenesis of CAV is unclear and may involve coronary thrombosis. We investigated whether HTx patients with CAV had higher platelet aggregation and turnover than HTx patients without CAV and healthy controls. Furthermore, we investigated the anti-platelet effect of low-dose aspirin in HTx patients.
We included 57 patients who had undergone HTx (median 8.3 years from HTx) and 57 healthy controls. Platelet aggregation was measured on-aspirin and off-aspirin using impedance aggregometry with adenosine diphosphate (ADP) and arachidonic acid (AA). We evaluated platelet turnover by flow cytometry, CAV burden by coronary angiography and echocardiography, and microvascular function by echocardiographic coronary flow velocity reserve (CFVR).
Off-aspirin, HTx patients with CAV (n = 21) had higher ADP-induced platelet aggregation than healthy controls (p < 0.01) and HTx patients without CAV (n = 36) (p < 0.05). Aspirin treatment reduced AA-induced platelet aggregation in both HTx groups, but HTx patients with CAV had higher platelet aggregation on-aspirin than HTx patients without CAV (p < 0.05). Platelet turnover did not differ between HTx patients with CAV and HTx patients without CAV (p > 0.34). HTx patients with lower CFVR values had higher platelet aggregation than HTx patients with higher CFVR values (p < 0.05).
Off-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV and healthy controls. On-aspirin, platelet aggregation was higher in HTx patients with CAV than in HTx patients without CAV. Aspirin monotherapy may not provide sufficient platelet inhibition in HTx patients with CAV.</abstract><cop>NEW YORK</cop><pub>Elsevier Inc</pub><pmid>32067865</pmid><doi>10.1016/j.healun.2020.01.1344</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-1466-0865</orcidid><orcidid>https://orcid.org/0000-0003-1520-1924</orcidid><orcidid>https://orcid.org/0000-0002-2522-9253</orcidid><orcidid>https://orcid.org/0000-0001-9309-4701</orcidid><orcidid>https://orcid.org/0000-0001-9043-8898</orcidid></addata></record> |
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| subjects | Aged Allografts aspirin Aspirin - therapeutic use Cardiac & Cardiovascular Systems cardiac allograft vasculopathy Cardiovascular System & Cardiology Coronary Angiography coronary artery disease Cross-Sectional Studies Denmark - epidemiology Female Follow-Up Studies Graft Rejection - diagnosis Graft Rejection - drug therapy Graft Rejection - mortality heart transplantation Heart Transplantation - adverse effects Humans Life Sciences & Biomedicine Male Middle Aged Platelet Aggregation - drug effects Platelet Aggregation Inhibitors - therapeutic use Respiratory System Retrospective Studies Science & Technology Surgery Survival Rate - trends Time Factors Transplantation treatment |
| title | Platelet aggregation and response to aspirin therapy in cardiac allograft vasculopathy |
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