Abstract Number: PB1707
Meeting: ISTH 2020 Congress
Background: Migraine is a chronic neurovascular disorder with a multifactorial aetiology. Association with patent foramen ovale (PFO) has been reported, with symptom regression after PFO closure. Increased platelet aggregation has been documented in migraineurs who partially benefit from treatment with antiplatelet drugs. To date, no further insights into platelet activation in migraineurs with PFO have been reported.
Aims: To characterize platelet activation, platelet thrombin generation capacity (pTGC) and microvesicle (MVs) profile in PFO patients with migraine on aspirin before and after PFO closure.
Methods: Platelet activation markers (Pselectin, activated glycoprotein IIb/IIIa, Tissue Factor [TF]) and MV profile were evaluated by whole blood flow cytometry in 61 patients the day before (T0) and six-months after (T1) PFO closure. pTGC was also assessed. Eight healthy subjects (HS), treated with aspirin for 7 days, were recruited as controls.
Results: The expression of Pselectin and activated glycoprotein IIb/IIIa was similar in PFO patients before and after PFO closure and in HS on the same pharmacological treatment. Conversely, platelet-associated TF expression was significantly higher in PFO patients at T0 compared to HS (3.3%±1.9 vs 2.3%±1.1, respectively; p=0.014) as well as pTGC. After PFO closure, platelet TF expression and pTGC significantly decreased, returning to the levels found in HS. The total number of circulating MVs decreased after PFO closure (108450±49099 at T0 vs 79777±32591 at T1 vs 65647±26506 MVs/µl in HS; p=0.0106) as well as the TF-positive MVs (23253±13083 at T0 vs 10644±5960 at T1 vs 13610±7180 MVs/µl in HS; p< 0.0001).
Conclusions: Classical markers of platelet activation behave similarly in PFO patients and HS both on aspirin. However, PFO patients show a significantly higher prothrombotic phenotype that may be involved in the clinical events and that is reverted only after foramen ovale closure.
To cite this abstract in AMA style:Canzano P, Trabattoni D, Brambilla M, Rossetti L, Becchetti A, Tremoli E, Camera M. Migraine in Patent Foramen Ovale Patients: Role of Platelet Activation [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/migraine-in-patent-foramen-ovale-patients-role-of-platelet-activation/. Accessed November 29, 2023.
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