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. 2010 Jul;33(7):E6-9.
doi: 10.1002/clc.20752.

Enhanced prothrombin formation and platelet activation in Chinese patients after transcatheter closure of atrial septal defect

Xiao-Chun Zeng  1 , Wei-Feng Wu, Kai Huang, Sheng-Lan Guo, Tang-Wei Liu
Affiliations

Enhanced prothrombin formation and platelet activation in Chinese patients after transcatheter closure of atrial septal defect

Xiao-Chun Zeng et al. Clin Cardiol. 2010 Jul.

Abstract

Background: The objective of this study was to investigate changes in coagulation activation and platelet activation after transcatheter closure of atrial septal defect (ASD) by determining the levels of specific markers over time to provide insight into preventing postprocedural embolism.

Hypothesis: We hypothesis that the activation status of coagulation and the platelet would be changed after the closure of ASD.

Methods: Forty consecutive patients who underwent transcatheter closure of ASD with the Lifetech ASD occluder (Lifetech Scientific, Shenzhen, China) were included in this prospective study. The serum level of prothrombin fragment 1 + 2 (F1 + 2) and expressions of P-selectin (CD62P) and platelet glycoprotein IIb/IIIa receptor (CD41a) on the surface of platelets were evaluated at baseline and at 1 day, 1 month, and 3 months after the closure.

Results: The median F1 + 2 level was 0.96 nmol/L. This increased to a maximal value of 1.43 nmol/L at 1 day after closure, but gradually returned to the baseline level at 1 month after closure and remained there at 3 months after closure (medians were 0.98 nmol/L and 1.08 nmol/L, respectively). Platelet surface expression of CD62P and CD41a decreased at 1 day, 1 month, and 3 months after closure. For CD62P, average expressions were 8.21% +/- 2.11%, 6.28% +/- 1.72%, 5.29% +/- 1.52%, and 4.41% +/- 1.11%, respectively, for baseline and 1 day, 1 month, and 3 months after closure. For CD41a, average expressions were 79.37% +/- 14.14%, 71.98% +/- 13.77, 56.69% +/- 13.05%, and 54.88% +/- 11.62%, respectively.

Conclusions: Transcatheter closure of ASD with the Lifetech ASD occluder was associated with significantly increased coagulation activation and decreased platelet activation. No evidence supporting the use of aspirin to prevent thrombus formation after closure was found.

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Figures

Figure 1
Figure 1
Levels of F1 + 2 at baseline, and at 1 day, 1 month, and 3 months after transcatheter closure of ASD. Results of pairwise comparison by Tukey test: 1 day vs baseline, P < 0.05; 1 month vs baseline P < 0.05; 3 months vs baseline, P > 0.05
Figure 2
Figure 2
Levels of CD62P expression on platelet surface at baseline, and at 1 day, 1 month, and 3 months after transcatheter closure of ASD. *Compared with baseline value, P < 0
Figure 3
Figure 3
Levels of CD41a expression on platelet surface at baseline, and at 1 day, 1 month, and 3 months after transcatheter closure of ASD. *Compared with baseline value, P < 0.05
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