Digoxin use is associated with increased platelet and endothelial cell activation in patients with nonvalvular atrial fibrillation
| Autor: | Yeon S. Ahn, Lawrence L. Horstman, Juan P. Zambrano, Howard J. Willens, Wenche Jy, Julio A. Chirinos, Joaquin J. Jimenez, Aurelio Castrellon, Agustin Castellanos, Robert J. Myerburg |
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| Rok vydání: | 2005 |
| Předmět: |
Blood Platelets
Digoxin medicine.medical_specialty medicine.drug_class Digitalis Calcium channel blocker Pharmacology Endothelial activation Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Platelet Platelet activation Aged biology business.industry Endothelial Cells Middle Aged medicine.disease biology.organism_classification Thrombosis Endothelial stem cell P-Selectin Cross-Sectional Studies Multivariate Analysis Cardiology Cardiology and Cardiovascular Medicine business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Heart Rhythm. 2:525-529 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2005.01.016 |
| Popis: | Objectives The purpose of this study was to determine whether digoxin use is associated with increased flow cytometric markers of endothelial cell and platelet activation in patients with nonvalvular atrial fibrillation (AF). Background Increased intracellular calcium is a key event in platelet activation, and several studies have demonstrated that digitalis activates platelets in vitro . Intracellular calcium also is a key regulator of endothelial cell function, and endogenous digitalis-like substances have been shown to affect biologic processes in endothelial cells. Methods We studied 30 patients with nonvalvular AF. We measured the levels of (1) platelet expression of P-selectin (CD62P), (2) platelet microparticles (PMP); and (3) endothelial microparticles (EMP) identified by anti-CD31 (EMP31) and by anti-E-selectin antibodies (EMP62E). Results Patients who were taking digoxin (n = 16; mean digoxin level=0.93 ng/dL) did not demonstrate any significant differences in clinical or echocardiographic characteristics compared with patients not taking digoxin (n = 14). Patients taking digoxin had significantly increased levels of CD62P expression in platelets and platelet-leukocyte conjugates and markedly increased markers of endothelial activation: EMP62E and EMP31. After adjusting for potential confounders (including age, congestive heart failure, coronary artery disease, ejection fraction, antiplatelet, β-blocker, and calcium channel blocker use), the differences persisted. Conclusions Digoxin use in patients with AF is associated with increased levels of endothelial and platelet activation. If digitalis activates endothelial cells and platelets at pharmacologic doses, use of digitalis in conditions such as AF could predispose to thrombosis and vascular events. |
| Databáze: | OpenAIRE |
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