Can platelet reactivity before transplantation predict cardiac allograft vasculopathy development?

    Authors

    Keywords

    platelet reactivity, heart transplantation, cardiac allograft vasculopathy

    DOI

    https://doi.org/10.15836/ccar2016.400

    Full Text

    **Introduction:** Cardiac allograft vasculopathy (CAV) is a relatively frequent complication after heart transplantation which limits long-term patient survival. CAV development and progression is related to enhanced platelet reactivity (PR). (1, 2) We sought to investigate the correlation between pretransplant PR level and CAV development 12 months after heart transplantation. **Patients and Methods:** We measured pretransplant PR of 48 patient using point of care platelet function testing device Multiplate. ADP was used as aggregation agonist. We compared PR levels patients who had CAV and patients without sings of CAV on coronary angiography 12 months after heart transplantation. **Results:** Five patients (10.4%) developed CAV after 12 months. Mean PR was 517 AUC (SD ± 178) and 488 AUC (SD ± 230) in patients with and without sings of CAV, respectively. There was no statistically significant difference in PR between the study groups (p=0.79). **Conclusion:** Our results show that baseline PR before transplantation is not linked with CAV development one year after heart transplantation. These results warrant further investigation on larger number of patients using other platelet activation agonists as well. Recipient reaction on donor heart changes with time. It would be reasonable to measure temporal PR changes to evaluate this parameter’s usefulness to predict or indicate CAV development.

    Literature

    1. Lund LH, Edwards LB, Kucheryavaya AY, Dipchand AI, Benden C, Christie JD, et al. International Society for Heart and Lung Transplantation. The Registry of the International Society for Heart and Lung Transplantation: thirtieth official adult heart transplant report--2013; focus theme: age. J Heart Lung Transplant. 2013;32(10):951–64. https://doi.org/10.1016/j.healun.2013.08.006
    2. Fateh-Moghadam S, Bocksch W, Ruf A, Dickfeld T, Scharti M, Pogátsa-Murray G, et al. Changes in surface expression of platelet membrane glycoproteins and progression of heart transplant vasculopathy. Circulation. 2000;102(8):890–7. https://doi.org/10.1161/01.CIR.102.8.890
    Cardiologia Croatica
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    Can platelet reactivity before transplantation predict cardiac allograft vasculopathy development?

    Extended Abstract
    Issue10-11
    Published
    Pages400
    PDF via DOIhttps://doi.org/10.15836/ccar2016.400
    platelet reactivity
    heart transplantation
    cardiac allograft vasculopathy

    Authors

    Jure SamardžićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Jana Ljubas MačekORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Marijan PašalićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Maja ČikešORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Boško SkorićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Ivo PlanincORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Hrvoje JurinORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia
    Davor MiličićORCIDUniversity of Zagreb School of Medicine, University Hospital Centre Zagreb, Zagreb, Croatia

    Full Text

    Introduction: Cardiac allograft vasculopathy (CAV) is a relatively frequent complication after heart transplantation which limits long-term patient survival. CAV development and progression is related to enhanced platelet reactivity (PR). (1, 2) We sought to investigate the correlation between pretransplant PR level and CAV development 12 months after heart transplantation.

    Patients and Methods: We measured pretransplant PR of 48 patient using point of care platelet function testing device Multiplate. ADP was used as aggregation agonist. We compared PR levels patients who had CAV and patients without sings of CAV on coronary angiography 12 months after heart transplantation.

    Results: Five patients (10.4%) developed CAV after 12 months. Mean PR was 517 AUC (SD ± 178) and 488 AUC (SD ± 230) in patients with and without sings of CAV, respectively. There was no statistically significant difference in PR between the study groups (p=0.79).

    Conclusion: Our results show that baseline PR before transplantation is not linked with CAV development one year after heart transplantation. These results warrant further investigation on larger number of patients using other platelet activation agonists as well. Recipient reaction on donor heart changes with time. It would be reasonable to measure temporal PR changes to evaluate this parameter’s usefulness to predict or indicate CAV development.

    Literature

    1. 1.
      Lund LH, Edwards LB, Kucheryavaya AY, Dipchand AI, Benden C, Christie JD, et al. International Society for Heart and Lung Transplantation. The Registry of the International Society for Heart and Lung Transplantation: thirtieth official adult heart transplant report--2013; focus theme: age. J Heart Lung Transplant. 2013;32(10):951–64.DOI
    2. 2.
      Fateh-Moghadam S, Bocksch W, Ruf A, Dickfeld T, Scharti M, Pogátsa-Murray G, et al. Changes in surface expression of platelet membrane glycoproteins and progression of heart transplant vasculopathy. Circulation. 2000;102(8):890–7.DOI