Abstract Number: PB0440
Meeting: ISTH 2020 Congress
Background: Myocardial infarction (MI) is the leading cause of mortality and is a condition where platelet hyperreactivity is commonly present. Nitric oxide (NO) likely plays a pivotal role in the pathogenesis platelet hyperreactivity. Methylated arginines-asymmetric dimethylarginine (ADMA) and its structural isomer symmetric dimethylarginine (SDMA)-are endogenous by-products of proteolysis that inhibit NO production.
Aims: In particular, we sought to identify the impact of impaired nitric oxide (NO) signaling to platelet reactivity in patients with acute coronary syndrome (ACS).
Methods: We assessed plasma ADMA and SDMA levels and analyzed the data, biospecimens, and adenosine diphosphate (ADP)-induced platelet aggregation from prospective, observational, multicenter ATLANTIS-SWITCH sub-study to assess its value in 344 consecutive ACS patients undergoing percutaneous coronary intervention (PCI). The plasma concentrations of SDMA and ADMA were evaluated using a Waters Acquity Ultra Performance Liquid Chromatograph coupled with a Waters TQ-S Triple-Quadrupole Mass Spectrometer. The mass spectrometer operated in the multiple-reaction monitoring (MRM)-positive electrospray ionization (ESI) mode.
Results: Hyper-responsiveness of platelets to ADP was inverse correlated with plasma concentrations of symmetric dimethylarginine (SDMA, r = -0.252, p < 0.001). Multivariate analysis identified that SDMA is a predictor factor for platelet hyperreactivity [adjusted OR 0.704, 95% CI 0.517-0.960; P =0.027].
Conclusions: We conclude that platelet hyperreactivity, where present in the context of ACS, may be engendered by impaired availability of NO signaling.
Study was supported by Polish Science Center grant “Preludium” number 2017/25/N/NZ5/00545.
|variable||Coefficient||p value||OR||2.5% OR||97.5% OR|
[Table 1. Multivariate regression analysis of factors which correlates with platelet hyperreactivity.]
To cite this abstract in AMA style:Eyileten C, Jarosz-Popek J, Soplinska A, Fitas Z, Nowak A, Zareba L, von Baumgarten G, Czajka P, Jakubik D, Siller-Matula J, Ufnal M, Postula M. The Importance of Altered Symmetric Dimethylarginine Levels with Platelet Hyperreactivity in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-importance-of-altered-symmetric-dimethylarginine-levels-with-platelet-hyperreactivity-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention/. Accessed September 24, 2023.
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