Tissue Factor in Patients With Acute Coronary Syndromes: Expression in Platelets, Leukocytes, and Platelet-Leukocyte Aggregates

• Published in: Arteriosclerosis, thrombosis, and vascular biology Vol. 28; no. 5; pp. 947 - 953
• Main Authors: Brambilla, Marta, Camera, Marina, Colnago, Deborah, Marenzi, Giancarlo, De Metrio, Monica, Giesen, Peter L., Balduini, Alessandra, Veglia, Fabrizio, Gertow, Karl, Biglioli, Paolo, Tremoli, Elena
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.05.2008; Hagerstown, MD Lippincott
• Subjects: Acute Coronary Syndrome - metabolism; Acute Coronary Syndrome - pathology; Acute Coronary Syndrome - physiopathology; Aged; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Coagulation - physiology; Blood Platelets - metabolism; Cardiology. Vascular system; Case-Control Studies; Cell Aggregation; Coronary heart disease; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart; Humans; Leukocytes - metabolism; Male; Medical sciences; Middle Aged; P-Selectin - metabolism; Platelet Activation - physiology; RNA, Messenger - metabolism; Thrombin - metabolism; Thromboplastin - genetics; Thromboplastin - metabolism; Thrombosis - physiopathology; Human; Leukocyte; Tissue factor; Cardiovascular disease; Coronary heart disease; Myocardial disease; Thrombosis; platelets; Vascular disease; Platelet; Atherosclerosis; Acute coronary syndrome; platelet-leukocyte aggregates
• ISSN: 1079-5642; 1524-4636; 1524-4636
• DOI: 10.1161/ATVBAHA.107.161471

OBJECTIVE—Activated platelets and circulating platelet-leukocyte aggregates (PLA) are significantly higher in patients with unstable angina than in those with stable angina (SA). Platelets from healthy subjects express TF on activation. The aim of this study was to investigate the expression of TF in PLA, in platelets, and in monocytes of acute coronary syndrome (ACS) patients compared to SA patients and healthy subjects (Controls). METHODS AND RESULTS—We enrolled 26 consecutive patients with ACS, 29 patients with SA, and 25 Controls. A significantly greater number of total and TF positive platelet-monocyte aggregates was found by flow cytometry in blood of ACS patients than in either SA patients (3-fold) or Controls (5-fold). ACS patients also had a significantly higher amount of TF-positive platelets than SA or Controls (>3-fold) and significantly higher thrombin generation capacity. TF mRNA expression in platelets was significantly higher in ACS patients than in SA or Controls. CONCLUSIONS—In ACS patients the greater expression of TF in platelets and PLA strengthens the link between platelet activation, blood coagulation, and thrombus formation and may further contribute to the hypercoagulability associated with the disease.