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Gurbel, P.A. et al.

Gurbel, Callahan, Malinin, Serebruany, Gillis,

Could stent design affect platelet activation? Results of the Platelet Activation in STenting (PAST) Study.

Platelet activation induced by coronary artery stenting may be related to stent design. In a prospective, randomized pilot study of 54 elective patients, platelet activation was analyzed before and at 2 hours, 24 hours, 5 days and 30 days post-implantation of either a closed-cell ( NIR) or open-cell (TETRA) stent. Platelet activation was less following NIR implantation as indicated by reduced aggregation to 5 mol adenosine diphosphate at 30 days (32.3 6.1% versus 94.5 18.9%; p = 0.02) and reduced expression of multiple surface markers (log mean fluorescence intensity): at 2 hours, CD 107a (22 13 versus 18 5; p = 0.045); at 24 hours, CD 31 (136 48 versus 110 48; p = 0.04), CD 151 (104 45 versus 91 31; p = 0.048), platelet leukocyte aggregates (95 40 versus 77 24; p = 0.018), and CD 107a (24 12 versus 17 4; p = 0.03); and at 30 days, CD 151 (99 33 versus 81 32; p = 0.03), platelet leukocyte aggregates (84 35 versus 72 31; p = 0.045) and PAC-1 (88 91 versus 72 30; p = 0.025). Ex vivo studies in explanted swine hearts revealed that the NIR stent produced less intimal prolapse and thus a smoother stent-vessel wall interface than the TETRA stent. In this pilot study, platelet activation was greater during the 30 days following implantation of an open-cell versus a closed-cell stent. This finding may be related to superior scaffolding, resulting in a smoother luminal contour after implantation of a closed-cell stent.[1]

References

Could stent design affect platelet activation? Results of the Platelet Activation in STenting (PAST) Study. Gurbel, P.A., Callahan, K.P., Malinin, A.I., Serebruany, V.L., Gillis, J. The Journal of invasive cardiology. (2002) [Pubmed]

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