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Relation of High Lipoprotein (a) Concentrations to Platelet Reactivity in Individuals with and Without Coronary Artery Disease

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Autor(es):
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Salsoso, Rocio [1] ; Dalcoquio, Talia F. [1] ; Furtado, Remo H. M. [2, 1] ; Franci, Andre [1] ; Barbosa, Carlos J. D. G. [3, 1] ; Genestreti, Paulo R. R. [1] ; Strunz, Celia M. C. [1] ; Lima, Viviane [1] ; Baracioli, Luciano M. [1] ; Giugliano, Robert P. [4, 5] ; Goodman, Shaun G. [6] ; Gurbel, Paul A. [7] ; Maranhao, Raul C. [8, 9] ; Nicolau, Jose C. [1]
Número total de Autores: 14
Afiliação do(s) autor(es):
[1] Univ Sao Paulo, Hosp Clin HCFMUSP, Inst Coracao InCor, Fac Med, Sao Paulo, SP - Brazil
[2] Hosp Israelita Albert Einstein, Sao Paulo - Brazil
[3] Hosp Coracao Brasil, Brasilia, DF - Brazil
[4] Harvard Med Sch, Boston, MA 02115 - USA
[5] Brigham & Womens Hosp, TIMI Study Grp, Cardiovasc Div, Dept Med, 75 Francis St, Boston, MA 02115 - USA
[6] Univ Toronto, Terrence Donnelly Heart Ctr, St Michaels Hosp, Toronto, ON - Canada
[7] Sinai Hosp Baltimore, Sinai Ctr Thrombosis Res & Drug Dev, Baltimore, MD - USA
[8] Univ Sao Paulo, Fac Pharmaceut Sci, Sao Paulo - Brazil
[9] Univ Sao Paulo, Sch Med, Lipid Metab Lab, Heart Inst InCor, Sao Paulo - Brazil
Número total de Afiliações: 9
Tipo de documento: Artigo Científico
Fonte: ADVANCES IN THERAPY; SEP 2020.
Citações Web of Science: 0
Resumo

Introduction Lipoprotein (a) {[}Lp(a)] is a risk factor for coronary artery disease (CAD). To the best of our knowledge, this is the first study addressing the relationship between Lp(a) and platelet reactivity in primary and secondary prevention. Methods Lp(a) was evaluated in 396 individuals with (82.3%) and without (17.7%) obstructive CAD. The population was divided into two groups according to Lp(a) concentrations with a cutoff value of 50 mg/dL. The primary objective was to evaluate the association between Lp(a) and adenosine diphosphate (ADP)-induced platelet reactivity using the VerifyNow (TM) P2Y(12)assay. Platelet reactivity was also induced by arachidonic acid and collagen-epinephrine (C-EPI) and assessed by Multiplate (TM), platelet function analyzer (TM) 100 (PFA-100), and light transmission aggregometry (LTA) assays. Secondary objectives included the assessment of the primary endpoint in individuals with or without CAD. Results Overall, 294 (74.2%) individuals had Lp(a) < 50 mg/dL {[}median (IQR) 13.2 (5.8-27.9) mg/dL] and 102 (25.8%) had Lp(a) >= 50 mg/dL {[}82.5 (67.6-114.5) mg/dL],P < 0.001. Univariate analysis in the entire population revealed no differences in ADP-induced platelet reactivity between individuals with Lp(a) >= 50 mg/dL (249.4 +/- 43.8 PRU) versus Lp(a) < 50 mg/dL (243.1 +/- 52.2 PRU),P = 0.277. Similar findings were present in individuals with (P = 0.228) and without (P = 0.669) CAD, and regardless of the agonist used or method of analysis (allP > 0.05). Finally, multivariable analysis did not show a significant association between ADP-induced platelet reactivity and Lp(a) >= 50 mg/dL {[}adjusted OR = 1.00 {[}(95% CI 0.99-1.01),P = 0.590]. Conclusion In individuals with or without CAD, Lp(a) >= 50 mg/dL was not associated with higher platelet reactivity. (AU)

Processo FAPESP: 14/01021-4 - Agregação e antiagregação plaquetária em pacientes com doença arterial coronária
Beneficiário:José Carlos Nicolau
Linha de fomento: Auxílio à Pesquisa - Temático
Processo FAPESP: 14/03742-0 - Projeto temático em medicina translacional: nanopartículas que se ligam a receptores de lipoproteínas no tratamento da aterosclerose, do infarto agudo de miocárdio, do pós-transplante de coração, do câncer e da endometriose
Beneficiário:Raul Cavalcante Maranhao
Linha de fomento: Auxílio à Pesquisa - Temático
Processo FAPESP: 17/26922-2 - A importância da agregação plaquetária nas diferentes formas de apresentação da Doença Arterial Coronária: da Aterosclerose subclínica às Síndromes Isquêmicas Miocárdicas Instáveis
Beneficiário:María Del Rocío Salsoso Rodríguez
Linha de fomento: Bolsas no Brasil - Pós-Doutorado