Soluble, platelet-bound, and total P-selectin as indices of platelet activation in congestive heart failure

Figures & data

Table I.  Base-line characteristics of patients and controls.

	Healthy (n=50)	IHD (n=70)	CHF (n=108)	P-value
Age	61±11	64±10	64±11	0.071
Male/Female	31/19	51/19	86/22	0.063
NYHA I–II	−	−	81	−
NYHA III–IV	−	−	27	−
LVEF (%)	72±12	64±8	34±8	<0.0001
SBP (mmHg)	132±12	138±13	124±19	<0.0001
DBP (mmHg)	78±9	80±10	73±11	<0.0001
Comorbidity
MI	…	61 (87%)	89 (82%)	0.397
HT	…	50 (71%)	51 (47%)	0.001
DM	…	9 (13%)	37 (34%)	0.001
Cholesterol (mmol/L)	5.7±0.99	4.6±1.4	4.5±1.19	<0.0001
Smoking (current)	8 (16%)	7 (10%)	14 (13%)	0.66
Previous CVA/TIA	…	3 (4%)	3 (3%)	0.59
AF	…	5 (7%)	10 (9%)	0.62
Treatment
ACE inhibitor or ARB	…	41 (59%)	102 (94%)	<0.0001
β-Blockers	…	38 (54%)	76 (70%)	0.029
Aspirin	…	48 (69%)	66 (61%)	0.59
Clopidogrel	…	9 (13%)	15 (14%)	0.84
Warfarin	…	5 (7%)	20 (19%)	0.033
Statin	…	48 (69%)	71 (66%)	0.695
Spironolactone	…	1 (1%)	24 (22%)	<0.0001

Data are mean±SD and analysis by one-way ANOVA or chi-square.

ACE=angiotensin-converting enzyme; ARB = angiotensin receptor blockers; AF = atrial fibrillation; CHF = congestive heart failure; CVA = cerebral vascular accident; DM = diabetes mellitus; DBP = diastolic blood pressure; H_T=hypertension; IHD = ischaemic heart disease; LVEF = left ventricular ejection fraction; MI = myocardial infarction; NYHA = New York Heart Association; SBP = systolic blood pressure; TIA = transient ischaemic attack

Table II.  Platelet abnormalities and activation in systolic heart failure.

	Healthy controls (n=50)	IHD (n=70)	Heart failure (n=108)	P-value
Platelet (×10^9/L)	263±54	255±62	257±88	0.87
sP-sel (ng/mL)	42 (30–52)	55 (43–85)	57.5 (37.6–105)	0.005 ^b
pP-sel (ng/mL)	270 (140–350)	225 (137.5–352.5)	271.5 (180–450)	0.197
%GCD62P	1.03 (0.64–1.71)	1.77 (1.13–3.63)	1.68 (0.77–3.62)	0.001 ^c
%GCD63	4.41 (2.04–6.20)	5.67 (3.42–9.48)	5.59 (2.68–9.04)	0.013 ^d

Data are mean±SD or median (IQR). Analysis by one-way ANOVA or Kruskal-Wallis test. Intergroup analyses by Tukey's post-hoc test:

^aCHF versus healthy controls.

^bDifference between both disease groups and healthy controls, not between groups.

^cDisease controls versus healthy controls only.

(b) Comparison of platelet abnormalities according to NYHA classification.

	NYHA I–II (n=81)	NYHA III–IV (n=27)	P-value
CD62P%G	1.40 (0.59–3.05)	2.60 (1.15–5.06)	0.036
CD63%G	5.52 (2.48–8.79)	6.97 (4.32–11.61)	0.175
sP-sel (ng/mL)	55 (36–100)	67.5 (42–150)	0.107
pP-sel (ng/mL)	315 (182.5–465)	225 (173–445)	0.372

Data are mean±SD or median (IQR). Analysis by one-way ANOVA or Kruskal-Wallis test.

(c) Platelet abnormalities and activation in ischaemic versus non-ischaemic heart failure.

	Non-ischaemic	Ischaemic	P-value
CD62P%G	2.16 (0.66–4.62)	1.57 (0.78–3.08)	0.45
CD63%G	6.97 (2.29–11.77)	5.58 (2.80–8.79)	0.684
sP-sel (ng/mL)	47.5 (36–90)	62.5 (38.5–107.5)	0.387
pP-sel (ng/mL)	325 (185–500)	260 (176.3–437.5)	0.763

(d) Platelet abnormalities according to severity of left ventricular ejection fraction.

	LVEF >35% (n=48)	LVEF ≤35% (n=60)	P-value
CD62P%G	1.97 (0.77–3.25)	1.46 (0.70–3.48)	0.707
CD63%G	5.59 (2.66–10.59)	5.54 (2.52–8.05)	0.366
sP-sel (ng/mL)	64 (39–110)	50 (35.6–90)	0.237
pP-sel (ng/mL)	272 (185–400)	285 (170–510)	0.513

Data are mean±SD or median (IQR). Analysis by one-way ANOVA or Kruskal-Wallis test.

CHF = congestive heart failure; IHD = ischaemic heart disease; IQR = interquartile range; LVEF = left ventricular ejection fraction; NYHA = New York Heart Association; pP-sel = total platelet P-selectin; sP-sel = soluble P-selectin.

CD62P%G = platelet surface p-selectin.

CD63%G = platelet surface CD63.

Table III.  Correlations between various platelet indices/markers.

	sP-sel	pP-sel	CD62P%G
pP-sel	0.374 P < 0.0001
CD62P%G	−0.257 P = 0.012	−0.205 P = 0.049
CD63%G	−0.097 P = 0.349	0.003 P = 0.978	0.665 P < 0.0001

pP-sel = total platelet P-selectin; sP-sel = soluble P-selectin.

and

Table IV.  Multivariate analysis of the predictive value of the platelet indices in heart failure patients.

Platelet indices	Log-rank statistic	P-value
sP-sel (ng/mL)	0.19	0.67
pP-sel (ng/mL)	0.25	0.62
%CD62P	0.51	0.47

pP-sel = total platelet P-selectin; sP-sel = soluble P-selectin.