Timing of clopidogrel loading dose on peripheral blood endothelial progenitor cells, SDF-1α and neointimal hyperplasia in carotid stenting.
Clin Hemorheol Microcirc
; 72(1): 23-38, 2019.
Article
em En
| MEDLINE
| ID: mdl-30320560
ABSTRACT
BACKGROUND:
Carotid stenting stimulates intimal proliferation through platelet and stem cell activation.OBJECTIVE:
The aim of this study is to evaluate whether the administration before or after carotid stenting of clopidogrel loading dose may play a role on circulating endothelial progenitor cells, stromal cell-derived factor-1α (SDF-1α) and neointimal hyperplasia.METHODS:
We recruited 13 patients (aged 74.52±7.23) with indication of carotid revascularization and in therapy with salicylic acid and statin. We blindly randomized them in two groups pre-carotid angioplasty with stent (Pre-CAS group) receiving 300âmg of clopidogrel before stenting, and post-carotid angioplasty with stent (Post-CAS group) receiving 300âmg after stenting. At the admission, we valued endothelial progenitor cells, SDF-1α and prospectively we repeated blood samples and measured intima-media thickness to estimate neointimal hyperplasia on the stent at 3, 6 and 12 months.RESULTS:
In the days following the CAS, we found a lower, statistically not significant, trend of endothelial progenitor cells in Pre-CAS group. The SDF-1α concentration tended to be lower at baseline in the pre-CAS group than in the post-CAS group and it did not show an increase in the observed time. On the contrary, in the Post-CAS group we observed a peak at six hours with a significant reduction (pâ<â0.001) at one day after stenting.The intima-media thickness was significantly lower in the Pre-CAS group than the Post-CAS group both at six months and 12 months after stenting.CONCLUSIONS:
Pre-stenting clopidogrel loading dose leaded to short-time modification of endothelial progenitor cells and platelets and to long-term a minor neointimal hyperplasia.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Inibidores da Agregação Plaquetária
/
Artérias Carótidas
/
Estenose das Carótidas
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Quimiocina CXCL12
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Células Progenitoras Endoteliais
/
Clopidogrel
Tipo de estudo:
Clinical_trials
Limite:
Aged
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Clin Hemorheol Microcirc
Assunto da revista:
ANGIOLOGIA
/
HEMATOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Itália