Indicators of ADP-induced platelet aggregation in patients with hypertension complicated by ischemic hemisphere stroke
DOI:
https://doi.org/10.14739/2310-1210.2017.5.110080Keywords:
hypertension, stroke, platelet aggregationAbstract
Arterial hypertension is one of the most significant factor in the development of cardio-vascular complications in patients due to elevated blood pressure, maintenance of disorders of endothelial function and coagulation system, as well as changes in platelets function.
The purpose of the work was to determine the characteristics of ADP-induced platelet aggregation in hypertension patients with ischemic hemisphere stroke.
Material and methods. The enrolled patients (n =152) were divided into 3 groups. The first one included 38 patients (an average age of 64 [57−72] years, (male 35%)) with arterial hypertension (AH) who reached the target level of blood pressure (according to the «office» measurements and ambulatory blood pressure monitoring). The second group included 96 AH patients aged 60 [64−71] years, (62% men) who did not reach the target level of blood pressure. And the third group involved 18 patients aged 66 [66−72] years (male 56%) with AH complicated by ischemic hemisphere stroke. Platelet aggregation was performed using light transmittance aggregation by optical analyzer (Solar, R.B.) with adenosine 5'-diphosphate (Sigma-Aldrich) at final concentration of 10.0 × 106 mol / L.
Results. There were significantly higher rates in hypertensive patients with ischemic hemisphere stroke of the maximum degree of platelet aggregation in 10 minutes (Tmax, 10min) by 18 % (78 [78−100] % vs. 66 [57−83] %, respectively, U = 554.0; p = 0.015), the maximum aggregation time (tTmax, 10min) by 34 % (78 [78−100] s vs. 66 [57−83] s, respectively, U = 554.0, p = 0.015). The degree of platelet aggregation at the end of the recording time (T 10min) and the area under the curve of the end of the 10 min. (AUC10min), respectively, by 19.4 % and 15 % than in AH patients who have not reached the target level of blood pressure.
Conclusions. Hypertensive patients who did and did not reach the target level of blood pressure showed no significant difference in analyzed parameters of ADP-induced platelet aggregation. However, there was approximately twofold increase in deaggregation (Kdesagg, 10min) among patients who did not reach the target level of blood pressure compared with those who reached it. Meanwhile, hypertensive individuals with ischemic hemisphere stroke had significantly higher ADP−induced aggregation parametrs as percentage of aggregation during 10 min. (T10min), the area under the aggregation curve at the end of 5th (AUC5min) and 10th min. (AUC10min) in comparison to hypertensives who did not reach the target blood pressure level. The influence of drugs on the studied parameters of ADP-induced platelet aggregation in patients is not established.
References
Burlova-Vasil'eva, M. K., Kravchenko, N. K., Savchuk, A. N., Katrii, T. B. & Mel'nik, V. S. (2014) Vliianie nizkomolekuliarnykh heparinov I streptokinazy na ADF-zavisimoiu ahrehatsiiu trombotsytov pri aterotromboticheskom ishemicheskom i kardioembolicheskom ishemicheskom insul'te na mertsatel'noi aritmii [Effect of low molecular weight heparins and streptokinase on ADP-induced platelet aggregation in patients with atherothrombotic ischemic stroke and cardioembolic ischemic stroke and atrial fibrillation]. Biofarmatsevticheskii zhurnal, 6 (2), 29−32 [in Russian].
Zhemaniuk, S. P., Syvolap, V. V. (2017) Osoblyvosti adrenalin-indukovanoi agregatsii trombotsytiv u khvorykh na essentsial'nu hipertenziiu v hostromu periodi pivkul'noho ishemichnoho insul'tu za danymy turbidymetrychnoi ahrehatometrii [Heart rate variability in essential hypertensive patients with ishaemic hemishere stroke]. Patolohiia, 1 (39), 68–74 [in Ukrainian].
Stakhovskaia, L. V., Kvasova, O. V., Prianikova, N. A., Efremova, N. M. & Skvortsova, V. I. (2000) Primenenie dipiridamola (kurantila) dlia vtorichnoi profilaktiki insul'ta [The use of dipyridamole (curantyl) for secondary prevention of stroke]. Zhurnal nevrolohii i psikhiatrii, 4, 28−31 [in Russian].
Sertsevo-sudinni zakhvoriuvannia. Klasifikatsiia, standarty diagnostiki ta likuvannia [Cardiovascular diseases: Classification, practical protocols of diagnosis and treatment] (2016) Ukrainian association of cardiology; chief editor academic V. M. Kovalenko [et al.]. Kiev: Morion [in Ukrainian].
Syvolap, V. V., Zhemaniuk, S. P. (2017) Vplyv normalizatsii (dosiahnennia tsil'ovoho rivnia) arterial'noho tysku na zminy pokaznykiv adrenalin-indukovanoi ahrehatsii trombotsitiv u khvorykh na hipertonichnu khvorobu [Effect of blood pressure normalization (reaching the target level) on epinephrine-induced platelet aggregation changes in patients with hypertension]. Zaporozhskii meditsynskii zhurnal, 3 (102), 270–275 [in Ukrainian].
Smertina, E. H., Prokopenko, S. V., Yonova, V. H., Tanashian, M. M. & Potylitsyna, V. V. (2009) Sostoianie sistemy hemostaza i funktsii endoteliia pri razlichnykh nodtipakh ishemicheskoho insul'ta v ostrom i vostanovitel'nom peridakh [Hemostasis system condition and endothelium functions during various pathogenesis types of ischemic strokes in the acute and regenerative periods]. Bulleten' sibirskoi meditsyny, 1 (2), 72–78, http://old.ssmu.ru/bull/09/01_2/16_s.pdf [in Russian].
Stepanova, Yu. I., Honchar, I. A. & Likhavev, S. A. (2012) Kharakteristika ahrehatsyonnoi sposobnosti trombotsytov u patsyentov s infarktom mozha pri vyrazhennom stenoze tserebral'nykh arterii [Characteristics of platelet aggregative ability at patients with brain infarction and marked stenosis of cerebral arteries]. Saratovskii nauchno-meditsynskii zhurnal, 8 (3), 770–774, http://www.ssmj.ru/system/files/201203-770-774.pdf [in Russian].
Htun, P., Fateh-Moghadam, S., Tomandl, B., Handschu, R., Klinger, K., Stellos, K., Garlichs, C., Daniel, W., & Gawaz, M. (2006) Course of platelet activation and рlatelet-leukocyte interaction in cerebrovascular ischemia. Stroke, 37(9), 2283–2287, doi.org/10.1161/01.STR.0000236638.75591.61.
Hayward, C. P. M., Moffat, K. A., Raby, A., Israels, S., Plumhoff, E., Flynn, G. & Zehnder, J. L. (2013) Development of North American consensus guidelines for medical laboratories that perform and interpret platelet function testing using light transmission aggregometry. Am J Clin Pathol, 134 (6), 955–963.
Benjamin, E. J., Blaha, M. J., Chiuve, St. E., Cushman, M., Das, S. R., Deo, R., de Ferranti, S. D., Floyd, J., Fornage, M., Gillespie, C., Isasi, C. R., Jiménez, M. C., Jordan, L. Ch., Judd, S. E., Lackland, D., Lichtman, J. H., Lisabeth, L., Liu, S., Longenecker, Ch. T., Mackey, R. H., Matsushita, K., Mozaffarian, D., Mussolino, M. E., Nasir, Kh., Neumar, R. W., Palaniappan, L., Pandey, D. K., Thiagarajan, R. R., Reeves, M. J., Ritchey, M., Rodriguez, C. J., Roth, Gr. A., Rosamond, W. D., Sasson, C., Towfighi Am., Tsao, C. W., Turner, M. B., Virani, S. S., Voeks, J. H., Willey, J. Z., Wilkins, J. T., Wu, J. H.Y., Alger, H. M., Wong, S. S., Muntner, P. & On behalf of the American Heart Association Statistics Committee and Stroke Statistics Subcommittee (2017) Heart disease and stroke statistics ‒ 2017 update: a report from the American Heart Association. Circulation, 135 (10): e146−e603, doi.org/10.1161/CIR.0000000000000485.
Iskra, T., Turaj, W., Słowik, A., Zwolińska, G., Strojny, J. & Szczudlik, A. (2006) [Hemostatic markers of endothelial injury in ischaemic stroke caused by large or small vessel disease]. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego, 21 (125), 429–433[in Polish].
Fateh-Moghadam, S., Htun, P., Tomandl, B, Sander, D., Stellos, K., Geisler, T., Langer, H., Walton, K., Handschu, R., Garlichs, C., Daniel & W. G., Gawaz, M. (2007) Hyperresponsiveness of platelets in ischemic stroke. Thromb Haemost, 97 (6), 974–978.
Cattaneo, M., Cerletti, C., Harrison, P., Hayward, C. P. M., D. Kenny, Nugent, D., Nurden, P., Rao, A. K., Schmaier, A. H., Watson, S. P., Lussana, F., Pugliano, M. T. & Michelson, A. D. (2013) Recommendation for the standardization of light transmission aggregometry: a consensus of the working party from the platelet physiology subcommittee of SSC/ISTH. JTH, 11 (6), 1183–1189.
Downloads
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
