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Published on: June 5, 2019
Usefulness of soluble and surface-bound P-selectin in detecting heightened platelet activity in patients with
C M O'Connor1, P A Gurbel, V L Serebruany
1Duke Clinical Research Institute, Durham, North Carolina 27710, USA. oconn002@onyx.mc.duke.edu
Insights
Platelet activation markers, P-selectin, are significantly elevated in patients with congestive heart failure (CHF). These findings suggest persistent platelet activation in CHF, independent of aspirin therapy.
Area of Science:
- Cardiology
- Hematology
- Biochemistry
Background:
- P-selectin is a key marker for platelet activation.
- P-selectin may be elevated in patients experiencing congestive heart failure (CHF).
Purpose of the Study:
- To prospectively compare platelet-bound and soluble P-selectin levels in CHF patients versus healthy controls.
- To investigate the effect of aspirin therapy on P-selectin levels in CHF.
Main Methods:
- Enzyme-linked immunosorbent assay (ELISA) was used to measure soluble P-selectin levels.
- Whole blood flow cytometry assessed platelet-bound P-selectin expression.
- 22 CHF patients and 14 healthy controls were included.
Main Results:
- Patients with CHF exhibited significantly elevated soluble P-selectin levels (186.6 ng/ml vs. 102.6 ng/ml in controls, p=0.017).
- Platelet-bound P-selectin expression was more than twofold higher in CHF patients (9.58% vs. 4.06% in controls, p=0.021).
- Aspirin therapy did not significantly alter P-selectin profiles in CHF patients.
Conclusions:
- Soluble and platelet-bound P-selectin are elevated in most severe CHF patients, indicating persistent platelet activation.
- The observed P-selectin elevation in CHF is independent of aspirin use.
- P-selectin serves as a potential biomarker for platelet activation in congestive heart failure.
Abstract:
P-selectin is an important marker of platelet activation and may be up-regulated in patients with congestive heart failure (CHF). We sought to prospectively compare simultaneously determined platelet and soluble P-selectin in patients with CHF and in healthy controls. Matched soluble levels by enzyme-linked immmunosorbent assay, and platelet-bound expression by whole blood flow cytometry of P-selectin were measured in 22 patients with CHF and compared with 14 healthy controls. Twelve patients were aspirin free and 10 patients were taking aspirin (81 to 500 mg/day). Patients with CHF had significantly elevated soluble P-selectin (186.6 +/- 82.7 ng/ml, p = 0.017) and more than twofold increased expression of platelet-bound P-selectin (9.58 +/- 7.16% of positive platelets, p = 0.021) compared with the P-selectin profile (102.6 +/- 29.0 ng/ml of plasma, and 4.06 +/- 1.21% of positive platelets, respectively) in controls. Aspirin therapy did not affect the P-selectin profile in patients with CHF. Despite antecedent aspirin therapy and interindividual variability of the P-selectin profile, soluble and platelet P-selectin were elevated in most patients with severe CHF, suggesting persistent platelet activation.
