Platelet nitric oxide responsiveness - A novel prognostic marker in acute coronary syndromes

Willoughby, SR, Stewart, S, Holmes, AS, Chirkov, YY and Horowitz, JD (2005) Platelet nitric oxide responsiveness - A novel prognostic marker in acute coronary syndromes. Arteriosclerosis Thrombosis And Vascular Biology, 25 12: 2661-2666. doi:10.1161/01.ATV.0000193622.77294.57


Author Willoughby, SR
Stewart, S
Holmes, AS
Chirkov, YY
Horowitz, JD
Title Platelet nitric oxide responsiveness - A novel prognostic marker in acute coronary syndromes
Journal name Arteriosclerosis Thrombosis And Vascular Biology   Check publisher's open access policy
ISSN 1079-5642
Publication date 2005
Sub-type Article (original research)
DOI 10.1161/01.ATV.0000193622.77294.57
Volume 25
Issue 12
Start page 2661
End page 2666
Total pages 6
Editor D. Heistad
Place of publication United States
Publisher Lippincott williams & Wilkins
Collection year 2005
Language eng
Subject C1
Abstract Objectives - Nitric oxide (NO) is critically important in the regulation of vascular tone and the inhibition of platelet aggregation. We have shown previously that patients with acute coronary syndromes (ACS) or stable angina pectoris have impaired platelet responses to NO donors when compared with normal subjects. We tested the hypotheses that platelet hyporesponsiveness to NO is a predictor of (1) cardiovascular readmission and/or death and (2) all-cause mortality in patients with ACS (unstable angina pectoris or non-Q-wave myocardial infarction). Methods and Results - Patients (n = 51) with ACS had evaluation of platelet aggregation within 24 hours of coronary care unit admission using impedance aggregometry. Patients were categorized as having normal (>= 32% inhibition of ADP-induced aggregation with the NO donor sodium nitroprusside; 10 mu mol/L; n = 18) or impaired (>= 32% inhibition of ADP-induced aggregation; n = 33) NO responses. We then compared the incidence of cardiovascular readmission and death during a median of 7 years of follow-up in these 2 groups. Using a Cox proportional hazards model adjusting for age, sex, index event, postdischarge medical treatment, revascularization status, left ventricular systolic dysfunction, concurrent disease states, and cardiac risk factors, impaired NO responsiveness was associated with an increased risk of the combination of cardiovascular readmission and/or death (relative risk, 2.7; 95% CI, 1.03 to 7.10; P = 0.041) and all-cause mortality (relative risk, 6.3; 95% CI, 1.09 to 36.7; P = 0.033). Conclusions - Impaired platelet NO responsiveness is a novel, independent predictor of increased mortality and cardiovascular morbidity in patients with high-risk ACS.
Keyword Hematology
Peripheral Vascular Disease
Nitric Oxide
Platelets
Acute Coronary Syndrome
Nitric Oxide Resistance
Stable Angina-pectoris
Artery-disease
Endothelial Dysfunction
Vasodilator Dysfunction
Cardiovascular Events
In-vivo
Resistance
Atherosclerosis
Nitroglycerin
Sensitivity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
2006 Higher Education Research Data Collection
School of Medicine Publications
 
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Created: Wed, 15 Aug 2007, 07:41:08 EST