Platelet-derived microparticle levels are significantly elevated in patients treated by elective stenting compared to subjects with diagnostic catheterization alone.

Significant platelet reactivity with endothelial damage may occur during percutaneous coronary intervention such as balloon angioplasty and elective stenting in patients with stenotic or occluded arteries in coronary artery disease. Activated platelets express several surface epitopes to aggregate and form heterotypic interactions with leukocytes and endothelial cells, secrete biomarkers to enhance their prothrombotic properties and also generate increased level of microparticles (PMPs). These events may contribute to subacute stent thrombosis induced by the procedure-mediated trauma. Our aim was to study the level of PMPs and other platelet activation markers at an early time point after stenting with bare metal stent in patients on aspirin antiplatelet pre-treatment, and these results were compared to data obtained from subjects with diagnostic catheterization alone. We found that at 15 minutes after the completion of stenting, the levels of PMPs (557 +/- 83/microl versus 325 +/- 42/microl), the platelet P-selectin expression (2.7 +/- 0.3% versus 1.99 +/- 0.1%) and the ratio of platelet-monocyte heterotypic aggregates (48 +/- 4% versus 38 +/- 3%) were significantly (p < 0.05) elevated in patients compared to unstented subjects, but no difference was found in soluble P-selectin values. We suggest that the observed cellular changes are early and sensitive markers to detect the platelet-activating effect of stent implantation.