Thromb Haemost 2002; 88(06): 924-930
DOI: 10.1055/s-0037-1613335
Review Article
Schattauer GmbH

Pretreatment with Oral Anticoagulants Decreases Platelet Activation in Patients Before and After Percutaneous Coronary Intervention

Jurriën M. ten Berg
1   Department of Cardiology, The Netherlands
,
Wim B. M. Gerritsen
2   Clinical Chemistry St Antonius Hospital Nieuwegein, The Netherlands
,
Fred J. L. M. Haas
2   Clinical Chemistry St Antonius Hospital Nieuwegein, The Netherlands
,
Johannes C. Kelder
1   Department of Cardiology, The Netherlands
,
Freek W. A. Verheugt
3   Department of Cardiology University Medical Center, Nijmegen, The Netherlands
,
H. W. Thijs Plokker
1   Department of Cardiology, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 20 July 2002

Accepted after resubmission 28 August 2002

Publication Date:
09 December 2017 (online)

Summary

Background

Platelet activation plays a major role in acute vessel closure after coronary angioplasty. In the randomized Balloon Angioplasty and Anticoagulation Study (BAAS), pretreatment with oral anticoagulants in addition to aspirin resulted in a 47% reduction of acute complications as compared with aspirin alone. This result may suggest a direct effect of oral anticoagulants on platelet activation.

Methods and Results

Patients were randomized to aspirin alone (group A, n = 26) or to aspirin plus oral anticoagulants started one week before angioplasty (group B, n = 26). Platelet response tests were performed 1 hour before (baseline) and 1 hour after intervention and on day 1. Platelet activation was measured by flow cytometry, as the number of antibody-positive platelets per 10,000 counted. Platelet function was evaluated with use of the PFA-100® analyzer. In group B, the median number of P-selectin-positive platelets was lower before (28 vs. 54, P = 0.018) and after (13 vs. 24, P = 0.377) angioplasty than in group A. Also the median decrease in the number of P-selectin-positive platelets during angioplasty was lower in group B (Δ = 4) than in group A (Δ = 30, P = 0.022). No further significant change was observed in platelet activation on day 1 in the two groups. The ability of platelets to become stimulated as measured with the PFA-100® analyzer was not affected by oral anticoagulants.

Conclusions

Pretreatment with oral anticoagulants resulted in less activated platelets before and after coronary angioplasty, which is in agreement with its clinical effect of reducing procedural complications. Platelet function was not affected by oral anticoagulants.

 
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