Atherosclerosis, myocardial infarction and primary hemostasis: Impact of platelets, von Willebrand factor and soluble glycoprotein VI. Issue 180 (August 2019)

• Record Type: Journal Article
• Authors: Villmann, Josepha-Maria; Burkhardt, Ralph; Teren, Andrej; Villmann, Thomas; Thiery, Joachim; Drogies, Tim
• Is Part Of: Thrombosis research. Issue 180(2019)
• Page Start: 98
• Page End: 104
• Publication Date: 2019-08
• Subjects: ACS Acute coronary syndrome -- CAD Coronary artery disease -- CRP C-reaktive protein -- FIB-C Clauss' Fibrinogen -- GPIb/IX/V Glycoprotein Ib/IX/V -- GPVI Glycoprotein VI -- Hct Hematocrit -- HPV Hypothetic patient vector -- MI Myocardial infarction -- MPV Mean platelet volume -- NSTEMI Non-ST-elevation myocardial infarction -- PCI Percutaneous coronary intervention -- PLT Platelet count -- sGPVI Soluble glycoprotein VI -- SOM Self-organizing maps -- STEMI ST-elevation myocardial infarction -- vWF Von Willebrand factor -- vWF-ratio Von Willebrand factor ratio -- vWF:RCo Von Willebrand factor ristocetin cofactor activity -- WBC White blood cell count; Primary hemostasis -- Acute coronary syndrome -- Platelets -- Mean platelet volume -- Soluble glycoprotein VI -- von-Willebrand-factor; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2019.06.014
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Introduction: Little is known about peril constellations in primary hemostasis contributing to an acute myocardial infarction (MI) in patients with already manifest atherosclerosis. The study aimed to establish a predicting model based on six biomarkers of primary hemostasis: platelet count, mean platelet volume, hematocrit, soluble glycoprotein VI, fibrinogen and von Willebrand factor ratio. Materials and methods: The biomarkers were measured in 1.491 patients with manifest atherosclerosis of the Leipzig (LIFE) heart study. Three groups were divided: patients with coronary artery disease (900 patients) and patients with atherosclerosis and either ST-elevated MI (404 patients) or Non-ST-elevated MI (187 patients). Correlations were analyzed by non-linear analysis with Self Organizing Maps. Classification and discriminant analysis was performed using Learning Vector Quantization. Results and conclusions. The combination of hemostatic biomarkers is regarded as valuable tool for identifying patients with atherosclerosis at risk for MI. Nevertheless, our study contradicts this belief. The biomarkers did not allow to establish a predicting model usable in daily patient care. Good specificity and sensitivity for the detection of MI was only reached in models including acute phase parameters (specificity 0, 9036, sensitivity 0, 7937 in men; 0, 8977 and 0, 8133 in women). In detail, hematocrit and soluble glycoprotein VI were significantly different between the groups. Significant dissimilarities were also found for fibrinogen (in men) and von Willebrand factor ratio. In contrast, the most promising parameters mean platelet volume and platelet count showed no difference, which is an important contribution to the controversy concerning them as new risk and therapy targets for MI. Highlights: MPV is no marker for acute coronary syndrome in patients with atherosclerosis. sGPVI and vWF-ratio show differences between patients with non-MI CAD versus CAD + MI. None of the biomarkers or combinations is sufficient for daily care risk calculation.