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Platelet Receptor Glycoprotein VI-Dimer Is Overexpressed in Patients with Atrial Fibrillation at High Risk of Ischemic Stroke.

Accepted version
Peer-reviewed

Type

Article

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Authors

Thomas, Patrick 
McKinney, Harriet 
Malcor, Jean-Daniel 

Abstract

Introduction  Atrial fibrillation (AF) increases the risk of ischemic stroke (IS). We hypothesized that the functional form of platelet receptor glycoprotein (GP) VI, GPVI-dimer, which binds to collagen and fibrin causing platelet activation, is overexpressed in patients with AF who have not had a stroke. Methods  A total of 75 inpatients with AF were recruited. None were admitted with or had previously had thrombotic events, including IS or myocardial infarction. Platelet surface expression of total GPVI, GPVI-dimer, and the platelet activation marker P-selectin were quantitated by whole blood flow cytometry. Serum biomarkers were collected in AF patients. Results were compared against patients contemporaneously admitted to hospital with similar age and vascular risk-factor profiles without AF (noAF, n  = 30). Results  Patients with AF have similar total GPVI surface expression ( p  = 0.58) and P-selectin exposure ( p  = 0.73) on their platelets compared with noAF patients but demonstrate significantly higher GPVI-dimer expression ( p  = 0.02 ). Patients with paroxysmal AF express similar GPVI-dimer levels compared with permanent AF and GPVI-dimer levels were not different between anticoagulated groups. Serum N-terminal pro b-type natriuretic peptide ( p  < 0.0001 ) and high sensitivity C-reactive protein ( p  < 0.0001 ) were significantly correlated with GPVI-dimer expression in AF platelets. AF was the only vascular risk factor that was independently associated with higher GPVI-dimer expression in the whole population ( p  = 0.02 ) . Conclusion  GPVI inhibition is being explored in clinical trials as a novel target for IS treatment. As GPVI-dimer is elevated in AF patients' platelets, the exploration of targeted GPVI-dimer inhibition for stroke prevention in patients at high risk of IS due to AF is supported.

Description

Keywords

atrial fibrillation, ischemic stroke, platelets, thrombosis

Journal Title

TH Open

Conference Name

Journal ISSN

2567-3459
2512-9465

Volume Title

Publisher

Georg Thieme Verlag KG
Sponsorship
British Heart Foundation (None)
British Heart Foundation (None)
This study was funded by a Special Project Grant from the British Heart Foundation (SP/13/7/30575 to SMJ, RWF and EAW). II’s work is supported by the UK NIHR (National Institute for Health Research), a British Heart Foundation Cambridge Centre for Cardiovascular Research Excellence Clinical Training Fellowship (RE/13/6/30180) and an Addenbrooke’s Charitable Trust Grant. KD is a Higher Specialist Scientist Trainee supported by NHS Health Education England. EAW is supported by the UK NIHR.

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2023-12-21 14:26:23
Published version
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2023-09-01 23:30:21
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