Korean Circ J.  2013 Sep;43(9):600-606. 10.4070/kcj.2013.43.9.600.

Effect of Abciximab on the Levels of Circulating Microparticles in Patients with Acute Myocardial Infarction Treated by Primary Angioplasty

• Cha JJ
• Kim JY
• Choi EY
• Min PK
• Cho M
• Lee DL
• Hong SY
• Yoon YW
• Lee BK
• Hong BK
• Rim SJ
• Kwon HM

• KMID: 2224815
• DOI: http://doi.org/10.4070/kcj.2013.43.9.600

Abstract

BACKGROUND AND OBJECTIVES
We investigated the effect of the additional use of abciximab during percutaneous coronary intervention (PCI) on the level of procoagulant microparticles (MPs) in patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary PCI.
SUBJECTS AND METHODS
In this study, we studied 86 patients with STEMI (72 men, age 58+/-13) who had undergone primary PCI. The decision to administer abciximab immediately prior to PCI was left to the discretion of the operator. Blood samples for analysis of MPs were obtained from the femoral artery before and after PCI. MPs with procoagulant potential were measured using a commercial kit. The cellular origins of MPs were determined by antigenic capture with specific antibodies.
RESULTS
Procoagulant MPs captured onto annexin V were not changed significantly after PCI {13.4+/-13.2 nM vs. 13.2+/-16.1 nM phosphatidylserine equivalent (PS eq), p=0.479}. Abciximab was used in 30 of 86 patients (35%) immediately prior to PCI. In patients who had undergone PCI without abciximab, no significant change in the level of MPs was observed after PCI. However, in the abciximab group, the level of circulating MPs was significantly decreased after PCI (12.0+/-10.7 nM vs. 7.8+/-11.7 nM PS eq, p=0.018). Levels of endothelial- and platelet-derived MPs also showed a significant reduction after PCI in the abciximab group.
CONCLUSION
Primary PCI with additional abciximab significantly reduced the level of procoagulant MPs regardless of their cellular origins in patients with STEMI.

Keyword

Cell-derived microparticles; Myocardial infarction; Platelet aggregation inhibitors

MeSH Terms

Angioplasty
Annexin A5
Antibodies, Monoclonal
Cell-Derived Microparticles
Femoral Artery
Humans
Immunoglobulin Fab Fragments
Male
Myocardial Infarction
Percutaneous Coronary Intervention
Platelet Aggregation Inhibitors
Annexin A5
Antibodies, Monoclonal
Immunoglobulin Fab Fragments
Platelet Aggregation Inhibitors

Figure

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  Fig. 1 Comparison of levels of microparticles captured on immobilized annexin V before and after coronary intervention in patients with ST-segment elevation myocardial infarction who had undergone coronary intervention without abciximab (n=56) or with abciximab (n=30). The line within the box denotes the median. The box spans the Interquartile Range (IQR). The whiskers extend to the minimum or maximum values within 1.5 IQR. PS: phosphatidylserine, PCI: percutaneous coronary intervention.

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  Fig. 2 Levels of microparticles captured with insolubilized monoclonal anti-CD31 (A), anti-CD146 (B), and anti-CD42b (C) antibodies before and after a coronary intervention in patients with ST-segment elevation myocardial infarction who had undergone coronary intervention without abciximab (n=56) or with abciximab (n=30). The line within the box denotes the median. The box spans the Interquartile Range (IQR). The whiskers extend to the minimum or maximum values within 1.5 IQR. PS: phosphatidylserine, PCI: percutaneous coronary intervention.

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  Fig. 3 Comparison of levels of microparticles captured on immobilized annexin V before and after coronary intervention in patients with ST-segment elevation myocardial infarction who had undergone coronary intervention without intracoronary aspiration (n=13) or with intracoronary aspiration (n=73). The line within the box denotes the median. The box spans the Interquartile Range (IQR). The whiskers extend to the minimum or maximum values within 1.5 IQR. PS: phosphatidylserine, PCI: percutaneous coronary intervention.

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  Fig. 4 Comparison of levels of microparticles captured on immobilized annexin V before and after coronary intervention in patients divided into 4 groups according to the use of intracoronary aspiration or abciximab during intervention. The line within the box denotes the median. The box spans the Interquartile Range (IQR). The whiskers extend to the minimum or maximum values within 1.5 IQR. PS: phosphatidylserine, PCI: percutaneous coronary intervention.

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