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Published on: January 28, 2020
Platelet FcγRIIa expression in patients with stable coronary artery disease
Robert Adamian1, Paul McCleary1, Toishi Sharma1
1Department of Medicine, Cardiovascular Research Institute, The University of Vermont, Burlington, Vermont, USA.
Insights
Patients with stable coronary artery disease (CAD) had lower average platelet Fc-gamma receptor IIa (FcɣRIIa) expression than those with myocardial infarction (MI). However, the range of FcɣRIIa was similar, suggesting potential prognostic value in stable CAD.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Hematology
Background:
- Fc-gamma receptor IIa (FcɣRIIa) amplifies platelet activation, and higher expression correlates with increased platelet reactivity.
- Elevated platelet FcɣRIIa is a significant risk factor for myocardial infarction (MI), stroke, and mortality.
Purpose of the Study:
- To compare platelet FcɣRIIa expression in patients with stable coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) versus patients with a history of MI.
- To investigate the potential prognostic implications of FcɣRIIa in stable CAD.
Main Methods:
- FcɣRIIa expression was quantified using flow cytometry in patients with stable CAD (n=49) undergoing PCI and compared to existing data from MI patients (n=197).
- Statistical comparisons utilized Mann-Whitney Rank Sum Test and Chi Squared analysis, with significance set at P < .05.
Main Results:
- Patients with stable CAD were older and had higher rates of prior MI, revascularization, diabetes, and hypertension compared to MI patients.
- Mean platelet FcɣRIIa expression was significantly lower in stable CAD patients (9746 ± 4316 molecules/platelet) compared to MI patients (11 479 ± 2405 molecules/platelet, P < .001).
- Despite lower average expression, the range of platelet FcɣRIIa in stable CAD patients (approx. 4500-27000 molecules/platelet) was similar to that observed in MI patients (approx. 6500-30000 molecules/platelet).
Conclusions:
- Patients with stable CAD exhibit lower average platelet FcɣRIIa expression than those with acute MI.
- The overlapping range of FcɣRIIa expression suggests that this marker may still hold prognostic significance in patients with stable CAD.
- Further research is warranted to fully elucidate the prognostic implications of platelet FcɣRIIa in stable CAD populations.
Objectives:
FcɣRIIa amplifies platelet activation and greater expression increases platelet reactivity. In patients with myocardial infarction (MI), high platelet FcɣRIIa identifies patients with an approximately 4-fold greater risk of MI, stroke, and death. We compared platelet FcɣRIIa in 2 groups: (1) patients who had not had an MI in the previous year and were undergoing cardiac catheterization and percutaneous coronary intervention (PCI) labeled as stable coronary artery disease (CAD), and (2) previously obtained results in patients with MI (n = 197).
Methods:
Patients undergoing cardiac catheterization and PCI were enrolled. FcɣRIIa expression was quantified with the use of flow cytometry. Comparisons were made with Mann-Whitney Rank Sum Test and Chi Squared analysis. Significance was defined as P less than .05.
Results:
Compared to patients with MI, patients with stable CAD (n = 49) were older (70 ± 9 years vs 63 ± 12 years) and were more likely to have had prior MI (43% vs 23%), prior revascularization (62% vs 33%), diabetes (35% vs 24%), and hypertension (98% vs 66%). In patients with stable CAD, platelet FcɣRIIa was, on average, lower than that seen in patients with acute MI (9746 ± 4316 vs 11 479 ± 2405 molecules/platelet, P less than .001). Patients with stable CAD exhibited a range of platelet FcɣRIIa (~4500 to ~27 000 molecules/platelet) similar to that seen in acute MI patients (~6500 to ~30 000 molecules/platelet).
Conclusions:
Compared to patients with MI, patients with stable CAD had, on average, lower platelet FcɣRIIa. However, the range of platelet FcɣRIIa was similar to that seen in patients with MI. These results support future studies designed to assess the prognostic implications of platelet FcɣRIIa in patients with stable CAD.
