Immature cell fractions after cessation of chronic P2Y12-inhibition in patients with coronary artery diseases
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Immature cell fractions after cessation of chronic P2Y12-inhibition in patients with coronary artery diseases. / Jäger, Bernhard; Vargas, Kris G; Haller, Paul M; Stojkovic, Stefan; Kaufmann, Christoph C; Freynhofer, Matthias; Quehenberger, Peter; Wagner, Oswald; Wojta, Johann; Huber, Kurt.
in: PLATELETS, Jahrgang 32, Nr. 6, 18.08.2021, S. 815-820.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Immature cell fractions after cessation of chronic P2Y12-inhibition in patients with coronary artery diseases
AU - Jäger, Bernhard
AU - Vargas, Kris G
AU - Haller, Paul M
AU - Stojkovic, Stefan
AU - Kaufmann, Christoph C
AU - Freynhofer, Matthias
AU - Quehenberger, Peter
AU - Wagner, Oswald
AU - Wojta, Johann
AU - Huber, Kurt
PY - 2021/8/18
Y1 - 2021/8/18
N2 - Changes in circulating cell populations may promote ischemic events that occur soon after discontinuation of P2Y12-inhibition. The aim of the study was to track the course of thrombopoietic and erythropoietic cells in patients with coronary artery diseases (CAD) after planned and physician-driven cessation of chronic P2Y12-inhibition (clopidogrel 75 mg OD, or prasugrel 10 mg OD, or ticagrelor 90 mg BID). Cell fractions were determined in 62 patients at baseline (the last day of P2Y12-inhibitor intake), on day-10, day-30, and day-180 thereafter. Immature platelet fraction (IPF), immature reticulocyte fraction (IRF), reticulocyte hemoglobin content (Ret-Hb) and red blood cell count (RBC) significantly increased from baseline to day-180 (IPF: p = .003; IRF: p = .013; Ret-Hb: p < .001; RBC: p = .044). Platelet count, leucocyte count and immature granulocyte fraction did not change over time (p = .561, p = .869, and p = .161, respectively). Fibrinogen levels significantly declined over time (p = .011), thrombopoietin levels increased in a non-significant manner (p = .379). We did not observe any significant interaction with choice of P2Y12-inhibitor, therefore suggesting a drug class-effect. Our data shows, that discontinuation of dual antiplatelet therapy is associated with raised thrombopoietic and erythropoietic activity in the bone marrow, without significant upregulation of thrombopoietin. This provides further evidence for a direct stimulation of precursor cells by P2Y12-inhibitors.
AB - Changes in circulating cell populations may promote ischemic events that occur soon after discontinuation of P2Y12-inhibition. The aim of the study was to track the course of thrombopoietic and erythropoietic cells in patients with coronary artery diseases (CAD) after planned and physician-driven cessation of chronic P2Y12-inhibition (clopidogrel 75 mg OD, or prasugrel 10 mg OD, or ticagrelor 90 mg BID). Cell fractions were determined in 62 patients at baseline (the last day of P2Y12-inhibitor intake), on day-10, day-30, and day-180 thereafter. Immature platelet fraction (IPF), immature reticulocyte fraction (IRF), reticulocyte hemoglobin content (Ret-Hb) and red blood cell count (RBC) significantly increased from baseline to day-180 (IPF: p = .003; IRF: p = .013; Ret-Hb: p < .001; RBC: p = .044). Platelet count, leucocyte count and immature granulocyte fraction did not change over time (p = .561, p = .869, and p = .161, respectively). Fibrinogen levels significantly declined over time (p = .011), thrombopoietin levels increased in a non-significant manner (p = .379). We did not observe any significant interaction with choice of P2Y12-inhibitor, therefore suggesting a drug class-effect. Our data shows, that discontinuation of dual antiplatelet therapy is associated with raised thrombopoietic and erythropoietic activity in the bone marrow, without significant upregulation of thrombopoietin. This provides further evidence for a direct stimulation of precursor cells by P2Y12-inhibitors.
KW - Blood Platelets/drug effects
KW - Coronary Artery Disease/complications
KW - Female
KW - Humans
KW - Male
KW - Middle Aged
KW - Purinergic P2Y Receptor Antagonists/adverse effects
U2 - 10.1080/09537104.2020.1803252
DO - 10.1080/09537104.2020.1803252
M3 - SCORING: Journal article
C2 - 32762577
VL - 32
SP - 815
EP - 820
JO - PLATELETS
JF - PLATELETS
SN - 0953-7104
IS - 6
ER -