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Thromb Haemost 2016; 115(02): 353-360
DOI: 10.1160/th15-03-0227
Blood Cells, Inflammation and Infection
Schattauer GmbH

Platelet density per monocyte predicts adverse events in patients after percutaneous coronary intervention

Bert Rutten
1   Department of Clinical Chemistry and Haematology, UMC Utrecht, Utrecht, the Netherlands
,
Mark Roest
1   Department of Clinical Chemistry and Haematology, UMC Utrecht, Utrecht, the Netherlands
,
Elizabeth A. McClellan
2   Department of Bioinformatics, Erasmus UMC, Rotterdam, the Netherlands
8   Department of Nephrology and the Einthoven Laboratory for Experimental Vascular Medicine, Leiden UMC, Leiden, the Netherlands
,
Jan W. Sels
3   Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands
,
Andrew Stubbs
2   Department of Bioinformatics, Erasmus UMC, Rotterdam, the Netherlands
,
J. Wouter Jukema
4   Department of Cardiology, Leiden UMC, Leiden, the Netherlands
,
Pieter A. Doevendans
5   Department of Experimental Cardiology, UMC Utrecht, Utrecht, the Netherlands
,
Johannes Waltenberger
6   Department of Cardiology, Maastricht UMC, Maastricht, the Netherlands
,
Anton-Jan van Zonneveld
7   Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany
,
Gerard Pasterkamp
5   Department of Experimental Cardiology, UMC Utrecht, Utrecht, the Netherlands
,
Philip G. de Groot   #
1   Department of Clinical Chemistry and Haematology, UMC Utrecht, Utrecht, the Netherlands
,
Imo E. Hoefer   #
5   Department of Experimental Cardiology, UMC Utrecht, Utrecht, the Netherlands
› Author Affiliations Financial support: This research was performed within the framework of the Center for Translational Molecular Medicine and supported by the Dutch Heart Foundation.
Further Information

Publication History

Received: 14 March 2015

Accepted after major revision: 24 August 2015

Publication Date:
22 November 2017 (online)

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Summary

Monocyte recruitment to damaged endothelium is enhanced by platelet binding to monocytes and contributes to vascular repair. Therefore, we studied whether the number of platelets per monocyte affects the recurrence of adverse events in patients after percutaneous coronary intervention (PCI). Platelet-monocytes complexes with high and low median fluorescence intensities (MFI) of the platelet marker CD42b were isolated using cell sorting. Microscopic analysis revealed that a high platelet marker MFI on monocytes corresponded with a high platelet density per monocyte while a low platelet marker MFI corresponded with a low platelet density per monocyte (3.4 ± 0.7 vs 1.4 ± 0.1 platelets per monocyte, P=0.01). Using real-time video microscopy, we observed increased recruitment of high platelet density monocytes to endothelial cells as compared with low platelet density monocytes (P=0.01). Next, we classified PCI scheduled patients (N=263) into groups with high, medium and low platelet densities per monocyte and assessed the recurrence of adverse events. After multivariate adjustment for potential confounders, we observed a 2.5-fold reduction in the recurrence of adverse events in patients with a high platelet density per monocyte as compared with a low platelet density per monocyte [hazard ratio=0.4 (95 % confidence interval, 0.2–0.8), P=0.01]. We show that a high platelet density per monocyte increases monocyte recruitment to endothelial cells and predicts a reduction in the recurrence of adverse events in patients after PCI. These findings may imply that a high platelet density per monocyte protects against recurrence of adverse events.

Supplementary Material to this article is available online at www.thrombosis-online.com.

Keywords

Monocytes - platelets - adverse events - percutaneous coronary intervention

# Prof. P.G. de Groot and Dr. I.E. Hoefer contributed equally to this study.


 

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