Abstract: FR-PO479

Increased Levels of Platelet Microparticles in CKD Patients with Acute Coronary Syndrome

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 303 CKD: Epidemiology, Outcomes - Cardiovascular

Authors

  • Mörtberg, Josefin LG, Danderyd Hospital, Stockholm, Sweden
  • Lundwall, Kristina, Danderyd Hospital, Stockholm, Sweden
  • Mobarrez, Fariborz, Karolinska Institutet, Solna, Sweden
  • Wallen, Hakan, Danderyd Hospital, Stockholm, Sweden
  • Jacobson, Stefan H., Danderyd Hospital, Stockholm, Sweden
  • Spaak, Jonas, Danderyd Hospital, Stockholm, Sweden
Background

Patients with CKD have worse outcome after an acute coronary syndrome (ACS). Traditional and nontraditional riskfactors, underutilization of coronary intervention, less active secondary prevention and lower adherence to medications all contribute to the poor prognosis. Microparticles MPs are circulating small sized vesicles shed from various cells upon activation, and they may induce biologically response and inter-cellular cross-talk. Platelet MPs(PMPs) are the most abundant MPs, and levels increase following myocardial infarction and in diabetes mellitus, hypertension, and CKD.
We hypothesized that ACS patients with CKD had further elevated PMPs compared with non CKD patients.

Methods

52 patients with ACS were included and fasting blood was acquired the day after admittance. Patients were divided in three groups according eGFR; average eGFR in group H (n=19) was 88 ml/min, in CKD 3 (n=16) 47 ml/min, and in CKD 4-5 (n=17) 19 ml/min.
PMPs were measured by flow cytometry and phenotyped according to size (0.3 – 1.0 µm) and expression of CD41 (GPIIb; platelet specific marker) together with platelet activation markers, CD40ligand (CD154) and P-selectin (CD62P)

Results

Levels of PMPs were elevated in CKD 4-5 patients, and levels of PMPs expressing platelet activation markers CD40 ligand(CD 154)) and p-selectin (CD62p) were higher in both CKD groups, compared with non CKD patients

Conclusion

In ACS patients, levels of PMPs as well as levels of PMPs expressing CD40 ligand (CD154) and/or p-selectin (CD62p) are significantly higher in CKD patients compared with non CKD patients. These finding indicates a higher platelet activation in CKD patients, which might contribute to the poorer outcome for CKD patients following a myocardial infarction.

Funding

  • Government Support - Non-U.S.