Increased Prolactin in Acute Coronary Syndromes as Putative Co-activator of ADP-stimulated P-Selectin Expression

Abstract

Prolactin and leptin are newly recognized platelet co-stimulators due to enhancement of ADP-induced platelet aggregation. The aim of our study was to assess whether both hormones prolactin and leptin play a role as co-activators of platelet activation in patients with acute coronary syndromes. Twenty-one patients with acute coronary syndromes, 10 with stable angina pectoris and 10 controls were studied. Patients with acute coronary syndromes showed significantly higher prolactin and leptin values and a significant increased P-selectin expression on platelets compared to patients with stable angina pectoris or controls. However, patients with acute myocardial infarction as a subgroup of acute coronary syndromes showed the highest prolactin levels as well as ADP stimulated P-selectin expression. In the myocardial infarction subgroup prolactin values showed a significant correlation to ADP stimulated P-selectin expression on platelets (r (2)=0.41; p=0.025), whereas leptin was not correlated. Our data indicate an association between increased prolactin values and enhanced P-selectin expression on platelets in patients with acute coronary syndromes. Therefore, the stress hormone prolactin could be a co-stimulator of platelet activation in these patients. In contrast, the putative platelet activator leptin does not seem to play a major role in acute coronary syndromes.

Hemostatic abnormalities in endocrine and metabolic disorders

“…Plasma PRL levels were significantly higher in 98 patients with unprovoked venous thromboembolism without congenital risk factors than those in healthy controls (100). Finally, according to other two small studies (101,102), hyperprolactinemia could be implicated in enhanced platelet reactivity seen in patients with ischemic stroke or acute coronary syndromes. Nevertheless, further larger case-control and intervention studies are needed that directly investigate the hemostatic and fibrinolytic disorders in patients with prolactinomas.…”

Assessment of prolactin associated platelet activation in ischemic stroke

“…Wallaschofski et al demonstrated the in vivo and in vitro dose-dependent expression of CD62p with prolactin in patients undergoing cerebrovascular ischemic event, and increased prolactin levels were shown in the blood of patients with ischemic stroke and transient ischemic attack. 14 The same investigator group also noted the higher rates of venous thromboembolism in patients with prolactinoma. 15 The authors attributed these results to increased platelet activation by prolactin via ADP.…”

Hormones and Arterial Stiffness in Patients with Chronic Kidney Disease

“…Therefore, an elevation of the prolactin levels is observed in patients with essential hypertension, acute coronary syndrome, ischemic stroke, preeclampsia and heart failure that accompanies postpartum cardiomyopathy [73][74][75][76][77] . In patients with advanced atherosclerosis, an increased expression of prolactin receptors has been reported.…”

“…In patients with advanced atherosclerosis, an increased expression of prolactin receptors has been reported. In vitro studies have also established the modulatory role of prolactin in the inflammatory response, stimulation of adhesion of mononuclear cells to the endothelium and vascular smooth muscle cell proliferation 75) . As the vascular effects of prolactin remain to be clarified, data remain scarce with regard to the association between the prolactin level and AS.…”