Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations
Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven. To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis inclu...
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| Veröffentlicht in: | The Annals of thoracic surgery 1996-04, Vol.61 (4), p.1188-1193 |
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| container_title | The Annals of thoracic surgery |
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| creator | Primack, Craig Walenga, Jeanine M. Koza, Michael J. Shankey, T. Vincent Pifarré, Roque |
| description | Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven.
To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis included whole-blood flow cytometry.
The highest percentages of activated platelets (positive for GMP-140 expression) were bound to leukocytes and erythrocytes in all CPB patients. Platelet-platelet activation did not reveal any marked differences between groups. However, in the platelet-cell bound region, increased ristocetin-stimulated platelet activation was observed from 30 minutes on CPB to 90 minutes after CPB with aprotinin (11.9% ± 5.1% to 33.1% ± 8.6%;
p < 0.05), but not without aprotinin (17.5% ± 0.1% to 17.9% ± 2.3%). Platelet autoactivation increased more in the untreated group with time on CPB.
This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to platelet-platelet interactions. |
| doi_str_mv | 10.1016/0003-4975(96)00016-1 |
| format | Article |
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To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis included whole-blood flow cytometry.
The highest percentages of activated platelets (positive for GMP-140 expression) were bound to leukocytes and erythrocytes in all CPB patients. Platelet-platelet activation did not reveal any marked differences between groups. However, in the platelet-cell bound region, increased ristocetin-stimulated platelet activation was observed from 30 minutes on CPB to 90 minutes after CPB with aprotinin (11.9% ± 5.1% to 33.1% ± 8.6%;
p < 0.05), but not without aprotinin (17.5% ± 0.1% to 17.9% ± 2.3%). Platelet autoactivation increased more in the untreated group with time on CPB.
This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to platelet-platelet interactions.</description><identifier>ISSN: 0003-4975</identifier><identifier>EISSN: 1552-6259</identifier><identifier>DOI: 10.1016/0003-4975(96)00016-1</identifier><identifier>PMID: 8607681</identifier><language>eng</language><publisher>Netherlands: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antigens, CD - metabolism ; Aprotinin - therapeutic use ; Cardiopulmonary Bypass ; Case-Control Studies ; Female ; Flow Cytometry - instrumentation ; Flow Cytometry - methods ; Flow Cytometry - statistics & numerical data ; Hemostatics - therapeutic use ; Humans ; Integrin beta3 ; Integrins - analysis ; Intraoperative Period ; Male ; Middle Aged ; P-Selectin - blood ; Platelet Activation - drug effects ; Platelet Membrane Glycoproteins - metabolism ; Serine Proteinase Inhibitors - therapeutic use</subject><ispartof>The Annals of thoracic surgery, 1996-04, Vol.61 (4), p.1188-1193</ispartof><rights>1996 The Society of Thoracic Surgeons</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-96c2e95fe7a870861bfee95c2b4deeebd58eca792236b172e9acb7081b9580513</citedby><cites>FETCH-LOGICAL-c393t-96c2e95fe7a870861bfee95c2b4deeebd58eca792236b172e9acb7081b9580513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0003-4975(96)00016-1$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8607681$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Primack, Craig</creatorcontrib><creatorcontrib>Walenga, Jeanine M.</creatorcontrib><creatorcontrib>Koza, Michael J.</creatorcontrib><creatorcontrib>Shankey, T. Vincent</creatorcontrib><creatorcontrib>Pifarré, Roque</creatorcontrib><title>Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations</title><title>The Annals of thoracic surgery</title><addtitle>Ann Thorac Surg</addtitle><description>Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven.
To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis included whole-blood flow cytometry.
The highest percentages of activated platelets (positive for GMP-140 expression) were bound to leukocytes and erythrocytes in all CPB patients. Platelet-platelet activation did not reveal any marked differences between groups. However, in the platelet-cell bound region, increased ristocetin-stimulated platelet activation was observed from 30 minutes on CPB to 90 minutes after CPB with aprotinin (11.9% ± 5.1% to 33.1% ± 8.6%;
p < 0.05), but not without aprotinin (17.5% ± 0.1% to 17.9% ± 2.3%). Platelet autoactivation increased more in the untreated group with time on CPB.
This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to platelet-platelet interactions.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antigens, CD - metabolism</subject><subject>Aprotinin - therapeutic use</subject><subject>Cardiopulmonary Bypass</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Flow Cytometry - instrumentation</subject><subject>Flow Cytometry - methods</subject><subject>Flow Cytometry - statistics & numerical data</subject><subject>Hemostatics - therapeutic use</subject><subject>Humans</subject><subject>Integrin beta3</subject><subject>Integrins - analysis</subject><subject>Intraoperative Period</subject><subject>Male</subject><subject>Middle Aged</subject><subject>P-Selectin - blood</subject><subject>Platelet Activation - drug effects</subject><subject>Platelet Membrane Glycoproteins - metabolism</subject><subject>Serine Proteinase Inhibitors - therapeutic use</subject><issn>0003-4975</issn><issn>1552-6259</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1996</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UMtOwzAQtBColMIfgJQTgkPAThonviBVFS-pEhc4W469qYySONhJpf49m6biiC_e2Zkde4eQa0YfGGX8kVKaxkuRZ3eC3yNgPGYnZM6yLIl5kolTMv-TnJOLEL4RJkjPyKzgNOcFmxOz6rzrbWvbqHFmqFVvXRu5KuqwhBr6SOne7qY2ijqsoO1DNLQG_NbZdhtp5Y113VA3rlV-H5X7ToUQuQ78YS5ckrNK1QGujveCfL08f67f4s3H6_t6tYl1KtI-FlwnILIKclXktOCsrACxTsqlAYDSZAVolYskSXnJctQqXaKQlSIraMbSBbmdfHGnnwFCLxsbNNS1asENQea5wJNyFC4nofYuBA-V7Lxt8O-SUTmGK8fk5JicFAeArdH_5ug_lA2Yv6Fjmsg_TTzgkjsLXgaNaWkw1oPupXH2_wd-AWe1i8s</recordid><startdate>19960401</startdate><enddate>19960401</enddate><creator>Primack, Craig</creator><creator>Walenga, Jeanine M.</creator><creator>Koza, Michael J.</creator><creator>Shankey, T. Vincent</creator><creator>Pifarré, Roque</creator><general>Elsevier Inc</general><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></search><sort><creationdate>19960401</creationdate><title>Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations</title><author>Primack, Craig ; Walenga, Jeanine M. ; Koza, Michael J. ; Shankey, T. Vincent ; Pifarré, Roque</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-96c2e95fe7a870861bfee95c2b4deeebd58eca792236b172e9acb7081b9580513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1996</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antigens, CD - metabolism</topic><topic>Aprotinin - therapeutic use</topic><topic>Cardiopulmonary Bypass</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Flow Cytometry - instrumentation</topic><topic>Flow Cytometry - methods</topic><topic>Flow Cytometry - statistics & numerical data</topic><topic>Hemostatics - therapeutic use</topic><topic>Humans</topic><topic>Integrin beta3</topic><topic>Integrins - analysis</topic><topic>Intraoperative Period</topic><topic>Male</topic><topic>Middle Aged</topic><topic>P-Selectin - blood</topic><topic>Platelet Activation - drug effects</topic><topic>Platelet Membrane Glycoproteins - metabolism</topic><topic>Serine Proteinase Inhibitors - therapeutic use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Primack, Craig</creatorcontrib><creatorcontrib>Walenga, Jeanine M.</creatorcontrib><creatorcontrib>Koza, Michael J.</creatorcontrib><creatorcontrib>Shankey, T. Vincent</creatorcontrib><creatorcontrib>Pifarré, Roque</creatorcontrib><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 Annals of thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Primack, Craig</au><au>Walenga, Jeanine M.</au><au>Koza, Michael J.</au><au>Shankey, T. Vincent</au><au>Pifarré, Roque</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations</atitle><jtitle>The Annals of thoracic surgery</jtitle><addtitle>Ann Thorac Surg</addtitle><date>1996-04-01</date><risdate>1996</risdate><volume>61</volume><issue>4</issue><spage>1188</spage><epage>1193</epage><pages>1188-1193</pages><issn>0003-4975</issn><eissn>1552-6259</eissn><abstract>Aprotinin significantly decreases postoperative blood loss, yet its exact mechanism of action remains unproven.
To study the cytoprotective effect on platelets, we collected blood samples from patients during cardiopulmonary bypass (CPB) operations performed with or without aprotinin. Analysis included whole-blood flow cytometry.
The highest percentages of activated platelets (positive for GMP-140 expression) were bound to leukocytes and erythrocytes in all CPB patients. Platelet-platelet activation did not reveal any marked differences between groups. However, in the platelet-cell bound region, increased ristocetin-stimulated platelet activation was observed from 30 minutes on CPB to 90 minutes after CPB with aprotinin (11.9% ± 5.1% to 33.1% ± 8.6%;
p < 0.05), but not without aprotinin (17.5% ± 0.1% to 17.9% ± 2.3%). Platelet autoactivation increased more in the untreated group with time on CPB.
This study demonstrates that in the presence of aprotinin, platelets remain unstimulated during CPB and the von Willebrand GPIb-mediated activatability of platelets is preserved, thus maintaining a viable platelet population. Most important, this study reveals that these mechanisms are more related to platelet-leukocyte than to platelet-platelet interactions.</abstract><cop>Netherlands</cop><pub>Elsevier Inc</pub><pmid>8607681</pmid><doi>10.1016/0003-4975(96)00016-1</doi><tpages>6</tpages></addata></record> |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present); EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection |
| subjects | Adult Aged Aged, 80 and over Antigens, CD - metabolism Aprotinin - therapeutic use Cardiopulmonary Bypass Case-Control Studies Female Flow Cytometry - instrumentation Flow Cytometry - methods Flow Cytometry - statistics & numerical data Hemostatics - therapeutic use Humans Integrin beta3 Integrins - analysis Intraoperative Period Male Middle Aged P-Selectin - blood Platelet Activation - drug effects Platelet Membrane Glycoproteins - metabolism Serine Proteinase Inhibitors - therapeutic use |
| title | Aprotinin modulation of platelet activation in patients undergoing cardiopulmonary bypass operations |
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