PMID- 27601054
OWN - NLM
STAT- MEDLINE
DCOM- 20180103
LR  - 20230829
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 14
IP  - 11
DP  - 2016 Nov
TI  - Mechanical circulatory support is associated with loss of platelet receptors 
      glycoprotein Ibalpha and glycoprotein VI.
PG  - 2253-2260
LID - 10.1111/jth.13497 [doi]
AB  - Essentials Relationship of acquired von Willebrand disease (VWD) and platelet 
      dysfunction is explored. Patients with ventricular assist devices and on 
      extracorporeal membrane oxygenation are investigated. Acquired VWD and platelet 
      receptor shedding is demonstrated in the majority of patients. Loss of platelet 
      adhesion receptors glycoprotein (GP) Ibalpha and GPVI may increase bleeding risk. 
      SUMMARY: Background Ventricular assist devices (VADs) and extracorporeal membrane 
      oxygenation (ECMO) are associated with bleeding that is not fully explained by 
      anticoagulant or antiplatelet use. Exposure of platelets to elevated shear in 
      vitro leads to increased shedding. Objectives To investigate whether loss of 
      platelet receptors occurs in vivo, and the relationship with acquired von 
      Willebrand syndrome (AVWS). Methods Platelet counts, coagulation tests and von 
      Willebrand factor (VWF) analyses were performed on samples from 21 continuous 
      flow VAD (CF-VAD), 20 ECMO, 12 heart failure and seven aortic stenosis patients. 
      Levels of platelet receptors were measured by flow cytometry or ELISA. Results 
      The loss of high molecular weight VWF multimers was observed in 18 of 19 CF-VAD 
      and 14 of 20 ECMO patients, consistent with AVWS. Platelet receptor shedding was 
      demonstrated by elevated soluble glycoprotein (GP) VI levels in plasma and 
      significantly reduced surface GPIbalpha and GPVI levels in CF-VAD and ECMO patients 
      as compared with healthy donors. Platelet receptor levels were also significantly 
      reduced in heart failure patients. Conclusions These data link AVWS and increased 
      platelet receptor shedding in patients with CF-VADs or ECMO for the first time. 
      Loss of the platelet surface receptors GPIbalpha and GPVI in heart failure, CF-VAD 
      and ECMO patients may contribute to ablated platelet adhesion/activation, and 
      limit thrombus formation under high/pathologic shear conditions.
CI  - (c) 2016 International Society on Thrombosis and Haemostasis.
FAU - Lukito, P
AU  - Lukito P
AD  - Haematology Unit, Alfred Hospital, Melbourne, Australia.
FAU - Wong, A
AU  - Wong A
AD  - Haematology Unit, Alfred Hospital, Melbourne, Australia.
FAU - Jing, J
AU  - Jing J
AD  - Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
FAU - Arthur, J F
AU  - Arthur JF
AD  - Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
FAU - Marasco, S F
AU  - Marasco SF
AD  - Cardiothoracic Unit, Alfred Hospital, Melbourne, Australia.
FAU - Murphy, D A
AU  - Murphy DA
AD  - Intensive Care Unit, Alfred Hospital, Melbourne, Australia.
FAU - Bergin, P J
AU  - Bergin PJ
AD  - Cardiology Unit, Alfred Hospital, Melbourne, Australia.
FAU - Shaw, J A
AU  - Shaw JA
AD  - Cardiology Unit, Alfred Hospital, Melbourne, Australia.
FAU - Collecutt, M
AU  - Collecutt M
AD  - Haematology Laboratory, Alfred Hospital, Melbourne, Australia.
FAU - Andrews, R K
AU  - Andrews RK
AD  - Australian Centre for Blood Diseases, Monash University, Melbourne, Australia.
FAU - Gardiner, E E
AU  - Gardiner EE
AD  - Department of Cancer Biology and Therapeutics, The John Curtin School of Medical 
      Research, The Australian National University, Canberra, Australia.
FAU - Davis, A K
AU  - Davis AK
AD  - Haematology Unit, Alfred Hospital, Melbourne, Australia.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20161020
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Platelet Glycoprotein GPIb-IX Complex)
RN  - 0 (Platelet Membrane Glycoproteins)
RN  - 0 (glycocalicin)
RN  - 0 (platelet membrane glycoprotein VI)
RN  - 0 (von Willebrand Factor)
RN  - 5Q7ZVV76EI (Warfarin)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aortic Valve Stenosis/physiopathology
MH  - Blood Platelets/*cytology/metabolism
MH  - Cohort Studies
MH  - *Extracorporeal Membrane Oxygenation
MH  - Female
MH  - Heart Failure/complications
MH  - *Heart-Assist Devices
MH  - Hemorrhage/complications
MH  - Heparin/therapeutic use
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Platelet Activation
MH  - Platelet Glycoprotein GPIb-IX Complex/*chemistry
MH  - Platelet Membrane Glycoproteins/*chemistry
MH  - Stress, Mechanical
MH  - Thrombosis
MH  - Warfarin/therapeutic use
MH  - Young Adult
MH  - von Willebrand Factor/chemistry
OTO - NOTNLM
OT  - extracorporeal membrane oxygenation
OT  - heart-assist devices
OT  - platelet glycoprotein Ib
OT  - platelet glycoprotein VI
OT  - von Willebrand disease
EDAT- 2016/10/21 06:00
MHDA- 2018/01/04 06:00
CRDT- 2016/09/08 06:00
PHST- 2016/06/08 00:00 [received]
PHST- 2016/08/22 00:00 [accepted]
PHST- 2016/10/21 06:00 [pubmed]
PHST- 2018/01/04 06:00 [medline]
PHST- 2016/09/08 06:00 [entrez]
AID - S1538-7836(22)03394-3 [pii]
AID - 10.1111/jth.13497 [doi]
PST - ppublish
SO  - J Thromb Haemost. 2016 Nov;14(11):2253-2260. doi: 10.1111/jth.13497. Epub 2016 
      Oct 20.