This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kamath, S. Articles by Lip, G. Y.H. Search for Related Content PubMed PubMed Citation Articles by Kamath, S. Articles by Lip, G. Y.H. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB ACETYLSALICYLIC ACID WARFARIN Related Collections Arrhythmias, clinical electrophysiology, drugs Coagulation Aggregation Platelets

(Stroke. 2002;33:1237.)
© 2002 American Heart Association, Inc.

Original Contributions

Platelet P-Selectin Levels in Relation to Plasma Soluble P-Selectin and ß-Thromboglobulin Levels in Atrial Fibrillation

Sridhar Kamath, MRCP; Andrew D. Blann, PhD; Graham J. Caine, BSc; David Gurney, MSc; Bernard S.P. Chin, MRCP Gregory Y.H. Lip, MD

From the Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK.

Correspondence to Professor G.Y.H. Lip, Haemostasis, Thrombosis, and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK. E-mail g.y.h.lip{at}bham.ac.uk

Background and Purpose— The increased risk of stroke and thromboembolism in atrial fibrillation (AF) may be related to a prothrombotic or hypercoagulable state, with abnormalities of hemostasis and platelet activation. To investigate the role of platelets in AF and the influence of antithrombotic therapy, we developed and then applied a new assay to detect the absolute amount of P-selectin per platelet (pP-selectin) based on cell lysis. Thus, pP-selectin in AF patients was compared with that of healthy controls and also with plasma soluble P-selectin (sP-selectin) and ß-thromboglobulin as established indices of platelet activation.

Methodsmdash; We studied 122 patients (mean [SD] age, 71 [9] years; 65 men) with chronic AF of >6 weeks’ duration: 34 were not on antithrombotic therapy, 30 were taking aspirin (75 to 300 mg/d), and 58 were fully anticoagulated with warfarin. pP-selectin was compared with sP-selectin and plasma ß-thromboglobulin levels (enzyme-linked immunosorbent assay). Results were compared with those of 23 healthy controls (mean [SD] age, 74 [9] years; 7 men) in sinus rhythm.

Results— pP-selectin was significantly lower in AF patients on no antithrombotic therapy (P0.03) than in healthy controls, but sP-selectin and ß-thromboglobulin levels were not significantly different and did not differ in patients taking aspirin or warfarin. However, pP-selectin was lower in patients with AF on aspirin than in those on warfarin (P<0.05). pP-selectin/sP-selectin correlated significantly in healthy controls (r0.47, P0.03) but inversely (r-0.43, P0.03) in AF patients on no antithrombotic therapy.

Conclusions— Lower levels of pP-selectin may represent a depletion of pP-selectin after platelet activation in AF. Aspirin further decreases pP-selectin levels compared with warfarin. On the basis of the principle of platelet lysis, we demonstrate that it is possible to determine the amount of P-selectin per platelet, which may be regulated in the megakaryocyte through a cyclooxygenase-dependent pathway.

Key Words: atrial fibrillation • ß-thromboglobulin • platelets • P-selectin

This article has been cited by other articles:

				M. Cleanthis, J. Smout, V. Bhattacharya, H. Ashour, A. Dyker, G. Ashley Ford, D. P Mikhailidis, and G. P. Stansby Soluble but Not Platelet P-selectin Correlates With Spontaneous Platelet Aggregation: A Pilot Study Clinical and Applied Thrombosis/Hemostasis, April 1, 2008; 14(2): 227 - 233. [Abstract] [PDF]

				A. Choudhury, I. Chung, A. D. Blann, and G. Y.H. Lip Platelet Surface CD62P and CD63, Mean Platelet Volume, and Soluble/Platelet P-Selectin as Indexes of Platelet Function in Atrial Fibrillation: A Comparison of "Healthy Control Subjects" and "Disease Control Subjects" in Sinus Rhythm J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1957 - 1964. [Abstract] [Full Text] [PDF]

				G. I Varughese, J. V Patel, J. Tomson, and G. Y H Lip Effects of blood pressure on the prothrombotic risk in 1235 patients with non-valvular atrial fibrillation Heart, April 1, 2007; 93(4): 495 - 499. [Abstract] [Full Text] [PDF]

				A. Choudhury, I. Chung, A. D. Blann, and G. Y. H. Lip Elevated Platelet Microparticle Levels in Nonvalvular Atrial Fibrillation: Relationship to P-Selectin and Antithrombotic Therapy Chest, March 1, 2007; 131(3): 809 - 815. [Abstract] [Full Text] [PDF]

				S. K. Nadar, A. D. Blann, S. Kamath, D. G. Beevers, and G. Y. H. Lip Platelet indexes in relation to target organ damage in high-risk hypertensive patients: A substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT) J. Am. Coll. Cardiol., July 21, 2004; 44(2): 415 - 422. [Abstract] [Full Text] [PDF]

				A. D. Blann, S. K. Nadar, and G. Y.H. Lip The adhesion molecule P-selectin and cardiovascular disease Eur. Heart J., December 2, 2003; 24(24): 2166 - 2179. [Abstract] [Full Text] [PDF]