Evaluation of Platelet Activation in Coronary Artery Disease – the Role of Flow Cytometry

Abstract

Within the last decade flow cytometry gave many new insights into the physiology and pathophysiology of platelet activation. This review provides an overview of the different flow-cytometric techniques which have been applied to study platelet activation in patients with coronary artery disease. CD62p is probably the most commonly used platelet activation marker in patients with coronary artery disease. Other antibodies (PAC 1, LIBS1, anti-FGN, etc.) can be utilized to monitor activation of the glycoprotein (GP) IIb/IIIa receptor. The analysis of microparticles, platelet-leukocyte conjugates, and intraplatelet signaling cascades provides additional information on the different steps of platelet activation. However, activation markers do not always adequately reflect the degree of platelet activation. Limitations of flow-cytometric techniques will be discussed. Flow cytometry shows that GP IIb/IIIa activation plays a pivotal role in coronary artery thrombosis which supports the development of GP IIb/IIIa receptor blockers to treat acute coronary syndromes. The GP IIb/IIIa-receptor occupancy assay is one of the first flow-cytometric platelet assays designed to become a part of routine hematology analysis. Flow-cytometric techniques contribute substantially to our understanding of platelet activation during acute coronary syndromes and thus to the development of new drugs and therapeutic approaches.