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Updated: May 22, 2025
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Plasma chemokines indicate enhanced bleeding in patients with chronic coronary syndrome undergoing percutaneous
Tobias Harm1, Shqipdona Lahu2, Katharina Mayer2
1Department of Cardiology and Angiology, University Hospital Tübingen, Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany.
Insights
In patients with coronary artery disease undergoing PCI, inhibiting Glycoprotein VI (GPVI) with revacept altered platelet function and chemokine levels. This may help identify bleeding risks and improve antiplatelet therapy efficacy.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Pharmacology
Background:
- Patients with coronary artery disease (CAD) face high risks of ischemic events and bleeding after percutaneous coronary intervention (PCI).
- Glycoprotein VI (GPVI) is vital for collagen-dependent thrombus formation and platelet balance.
Purpose of the Study:
- To investigate the impact of GPVI inhibition with revacept on platelet function and chemokine profiles in CAD patients undergoing PCI.
- To determine if GPVI-associated chemokine changes can predict bleeding events.
Main Methods:
- A randomized, double-blind trial involving 334 CAD patients undergoing elective PCI.
- Ex vivo platelet function tests and plasma chemokine concentration analyses were performed.
- Changes in GPVI-dependent chemokines were correlated with bleeding events during 30-day follow-up.
Main Results:
- Revacept treatment altered platelet function and circulating chemokine concentrations.
- Patients experiencing bleeding events showed a distinct chemokine profile linked to altered platelet function.
- GPVI-associated chemokine and platelet function changes improved diagnostic value for bleeding risk in CAD patients.
Conclusions:
- Platelet-derived chemokines correlate with platelet function post-antiplatelet therapy, potentially identifying high bleeding risk patients.
- Assessing chemokines may predict bleeding events in CAD patients.
- Revacept's modulation of platelet chemokines contributes to antiplatelet efficacy and may reduce bleeding risk.
Background:
Patients with coronary artery disease (CAD) are at increased risk of developing ischemic events and contemporary antiplatelet therapy often leads to bleeding events following percutaneous coronary intervention (PCI). Glycoprotein VI (GPVI) is the key receptor of collagen-dependent thrombus formation and crucial for platelet homeostasis.
Methods:
We analysed the influence of GPVI inhibition with revacept in a randomized double-blinded trial enrolling 334 patients with CAD undergoing elective PCI. Ex vivo platelet function analyses were assessed alongside plasma chemokine concentrations. We then elucidate changes of GPVI-dependent chemokine concentrations in patients with bleeding events during the 30-day clinical follow-up.
Results:
Changes in platelet function occur in patients with revacept treatment and are associated with a characteristic alteration of circulating chemokine concentrations. Further, patients with adverse bleeding events share a distinct fingerprint of chemokines that is associated with modulation of in vitro platelet functions. In addition, assessment of GPVI-associated changes in chemokine signalling and platelet functions demonstrated an increased diagnostic value in patients with CAD and might improve early risk discrimination for bleeding events.
Conclusion:
The composition of platelet-derived chemokines correlated with platelet functions following antiplatelet treatment. Thus, assessment of chemokines may offer the perspective to identify patients at increased risk for bleeding events. Likewise, modulation of platelet chemokines in patients with revacept treatment contributes to the efficacy of antiplatelet treatment and might attenuate pathophysiological cascades leading to haemorrhagic diathesis in patients with CAD.
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