Pilot Study on Shear-induced Platelet Aggregation in Acute Coronary Syndromes

Institut National de la Santé Et de la Recherche Médicale, France97 enrolled

Overview

The purpose of this study is to determine whether shear-induced platelet aggregation is able to discriminate first acute coronary syndrome (ACS) from recurrent ACS

Predictive factors of recurrence of ACS are not well determined. Platelet aggregation and leucocyte activation seem to be involved in the pathogenesis. The aim of our study is to compare SIPA, platelet activation and platelet-leucocytes aggregates on the onset of the ACS and 3 months later in 2 groups of patients scheduled for a first episode of ACS or recurrent ACS .

Study Type

OBSERVATIONAL

Enrollment

Conditions

Angina, Unstable

Eligibility

Sex: ALLMin age: 18 YearsMax age: 85 Years

Medical Language ↔ Plain English

Inclusion Criteria: over 18 years old. informed consent signed. acute coronary syndrome not associated with co-morbidity as bleeding diathesis or myocardial infarction during the procedure. clinical symptoms in agreement with myocardial infarction during the preceding 24 hours. CK OR troponin elevation and one or more of the following criteria: ECG modifications transient ST elevation\>1 mm. new inversion of ST \<1 mm on 2 contiguous derivations. Exclusion criteria: Acute coronary syndrome with persistent ST elevation. Angioplasty in emergency before blood sampling. Inflammatory disease or cancer. Coagulation abnormalities. Antiphospholipid syndrome. Treatment by vitamin K antagonist. Severe disease with life expectancy lower than 2 years. One-year follow up impossible.

Locations (1)

Bichat Hospital

Paris, France

Outcomes

Primary Outcomes

Measurement of platelet aggregation induced by shear rates

Using rotational viscometer

Time frame: Day 1, Month 3

Secondary Outcomes

Measurement of platelet aggregation induced by ADP (Adenosine 5'-diphosphate)

Measured by turbidimetry in the of the agonist, at 37°C in an aggregometer (model 490, Chonolog)

Time frame: Day 1, Month 3

Measurement of P-selectin membrane density

By flow cytometry (EPICS Profile, Beckman, Coulter)

Time frame: Day 1, Month 3

Measurement of activated alphaIlbbeta3 membrane density

By flow cytometry (EPICS Profile, Beckman, Coulter)

Time frame: Day 1, Month 3

Determination of the number of platelet-leucocyte aggregates in the circulating blood

By flow cytometry, using antibodies specific to platelets (CD41), polymorphonuclear cells (CD15) and monocytes labelled with a fluorochrome (FITC)

Time frame: Day 1, Month 3

Measuring Von Willebrand factor

Carried out on frozen plasma of all patients

Time frame: Day 1, Month 3

Data from ClinicalTrials.gov

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