Platelet Activation in Patients with Atherosclerotic Renal Artery Stenosis Undergoing Stent Revascularization

被引:14
作者
Haller, Steven [1 ]
Adlakha, Satjit
Reed, Grant [2 ]
Brewster, Pamela
Kennedy, David [3 ]
Burket, Mark W.
Colyer, William
Yu, Haifeng
Zhang, Dong
Shapiro, Joseph I.
Cooper, Christopher J.
机构
[1] Univ Toledo, Med Ctr, Dept Med, Coll Med, Toledo, OH 43614 USA
[2] Brigham & Womens Hosp, Dept Med, Boston, MA 02115 USA
[3] Cleveland Clin Fdn, Dept Cell Biol, Cleveland, OH 44195 USA
来源
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2011年 / 6卷 / 09期
关键词
PERCUTANEOUS CORONARY INTERVENTION; SOLUBLE CD40 LIGAND; TUBULAR EPITHELIAL-CELLS; MEDICAL PROGRESS; CLOPIDOGREL; RELEASE; ANTIPLATELET; INHIBITION; ANTAGONISTS; EXPRESSION;
D O I
10.2215/CJN.03140411
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background and objectives Soluble CD40 ligand (sCD40L) is a marker of platelet activation; whether platelet activation occurs in the setting of renal artery stenosis and stenting is unknown. Additionally, the effect of embolic protection devices and glycoprotein IIb/IIIa inhibitors on platelet activation during renal artery intervention is unknown. Design, setting, participants, & measurements Plasma levels of sCD40L were measured in healthy controls, patients with atherosclerosis without renal stenosis, and patients with renal artery stenosis before, immediately after, and 24 hours after renal artery stenting. Results Soluble CD40L levels were higher in renal artery stenosis patients than normal controls (347.5 +/- 27.0 versus 65.2 +/- 1.4 pg/ml, P < 0.001), but were similar to patients with atherosclerosis without renal artery stenosis. Platelet-rich emboli were captured in 26% (9 of 35) of embolic protection device patients, and in these patients sCD40L was elevated before the procedure. Embolic protection device use was associated with a nonsignificant increase in sCD40L, whereas sCD40L declined with abciximab after the procedure (324.9 +/- 42.5 versus 188.7 +/- 31.0 pg/ml, P = 0.003) and at 24 hours. Conclusions Atherosclerotic renal artery stenosis is associated with platelet activation, but this appears to be related to atherosclerosis, not renal artery stenosis specifically. Embolization of platelet-rich thrombi is common in renal artery stenting and is inhibited with abciximab. Clin J Am Soc Nephrol 6: 2185-2191, 2011. doi:10.2215/CJN.03140411
引用
收藏
页码:2185 / 2191
页数:7
相关论文
共 38 条
[1]   Comparison of platelet function and morphology in patients undergoing percutaneous coronary intervention receiving Bivalirudin versus Unfractionated heparin versus Clopidogrel pretreatment and Bivalirudin [J].
Anand, Sunil X. ;
Kim, Michael C. ;
Kamran, Mazullah ;
Sharma, Samin K. ;
Kini, Annapoorna S. ;
Fareed, Jawed ;
Hoppensteadt, Debra A. ;
Carbon, Frank ;
Cavusoglu, Erdal ;
Varon, David ;
Viles-Gonzalez, Juan F. ;
Badimon, Juan J. ;
Marmur, Jonathan D. .
AMERICAN JOURNAL OF CARDIOLOGY, 2007, 100 (03) :417-424
[2]   CD40L stabilizes arterial thrombi by a β3 integrin-dependent mechanism [J].
André, P ;
Prasad, KSS ;
Denis, CV ;
He, M ;
Papalia, JM ;
Hynes, RO ;
Phillips, DR ;
Wagner, DD .
NATURE MEDICINE, 2002, 8 (03) :247-252
[3]   The CD40/CD40 Ligand System Linking Inflammation With Atherothrombosis [J].
Antoniades, Charalambos ;
Bakogiannis, Constantinos ;
Tousoulis, Dimitris ;
Antonopoulos, Alexios S. ;
Stefanadis, Christodoulos .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2009, 54 (08) :669-677
[4]   Renal artery stenting slows the rate of renal function decline [J].
Arthurs, Zachary ;
Starnes, Benjamin ;
Cuadrado, Daniel ;
Sohn, Vance ;
Cushner, Howard ;
Andersen, Charles .
JOURNAL OF VASCULAR SURGERY, 2007, 45 (04) :726-731
[5]   Effects of clopidogrel on soluble CD40 ligand and on high-sensitivity C-reactive protein in patients with stable coronary artery disease -: art. no. e1 [J].
Azar, RR ;
Kassab, R ;
Zoghbi, A ;
Aboujaoudé, S ;
El-Osta, H ;
Ghorra, P ;
Germanos, M ;
Salamé, E .
AMERICAN HEART JOURNAL, 2006, 151 (02) :521.e1-521.e4
[6]   Comparative effectiveness of management strategies for renal artery stenosis: A systematic review [J].
Balk, Ethan ;
Raman, Gowri ;
Chung, Mei ;
Ip, Stanley ;
Tatsioni, Athina ;
Alonso, Alvaro ;
Chew, Priscilla ;
Gilbert, Scott J. ;
Lau, Joseph .
ANNALS OF INTERNAL MEDICINE, 2006, 145 (12) :901-912
[7]   Immunohistochemistry of thrombi following iliac venous stenting: A novel model of venous thrombosis [J].
Burches, Bobby ;
Karnicki, Krzysztof ;
Wysokinski, Waldemar ;
McBane, Robert D., III .
THROMBOSIS AND HAEMOSTASIS, 2006, 96 (05) :618-622
[8]   Variants of the CD40 gene but not of the CD40L gene are associated with coronary artery calcification in the Diabetes Heart Study (DHS) [J].
Burdon, KP ;
Langefeld, CD ;
Beck, SR ;
Wagenknecht, LE ;
Carr, JJ ;
Rich, SS ;
Freedman, BI ;
Herrington, D ;
Bowden, DW .
AMERICAN HEART JOURNAL, 2006, 151 (03) :706-711
[9]   CD40 ligand influences platelet release of reactive oxygen intermediates [J].
Chakrabarti, S ;
Varghese, S ;
Vitseva, O ;
Tanriverdi, K ;
Freedman, JE .
ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY, 2005, 25 (11) :2428-2434
[10]   Embolic protection and platelet inhibition during renal artery stenting [J].
Cooper, Christopher J. ;
Haller, Steven T. ;
Colyer, William ;
Steffes, Michael ;
Burket, Mark W. ;
Thomas, William J. ;
Safian, Robert ;
Reddy, Bhagat ;
Brewster, Pamela ;
Ankenbrandt, Mary Ann ;
Virmani, Renu ;
Dippel, Eric ;
Rocha-Singh, Krishna ;
Murphy, Timothy P. ;
Kennedy, David J. ;
Shapiro, Joseph I. ;
D'Agostino, Ralph D. ;
Pencina, Michael J. ;
Khuder, Sadik .
CIRCULATION, 2008, 117 (21) :2752-2760