Clopidogrel inhibits platelet-leukocyte interactions and thrombin receptor agonist peptide-induced platelet activation in patients with an acute coronary syndrome
Zihui Xiao, PhD* and
Pierre Théroux, MD*,*
* Department of Medicine, Montreal Heart Institute, and University of Montreal, Montreal, Quebec, Canada
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Figure 1 Representative scatter plots of flow cytometric settings for detecting platelet-monocyte and platelet-neutrophil conjugates using anti-CD14-PC5 and anti-CD42a-FITC. (Left panel) The leukocyte populations are distinguished by their granularities (SS = side scale) and CD14 densities (anti-CD14-PC5). The cell population with higher CD14-PC5 intensity but lower granularity represents monocytes (gate B), whereas the population with lower CD14 intensity but higher granularity represents neutrophils (gate I). Monocytes (gate B) and neutrophils (gate I) are further analyzed by CD42a-FITC (platelet marker) versus CD14-PC5 (middle and right panels, respectively). The particles positive for both anti-CD42a-FITC and anti-CD14-PC5 in region "2" of the scatter plot are identified as platelet-monocyte conjugates (middle panel) and platelet-neutrophil conjugates (right panel).
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Figure 2 Soluble CD40L (n = 21; left panel) and soluble P-selectin (n = 15; right panel) plasma levels in patients with acute coronary syndrome before and 24 h after clopidogrel administration.
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Figure 3 Percentage of monocytes with bound platelets (left panel) and number of platelets bound per monocyte (right panel) in normal volunteers (control = no clopidogrel) and in acute coronary syndrome patients before and 24 h after a loading dose of clopidogrel. Either adenosine diphosphate (ADP) (10 µmol/l) or thrombin receptor agonist peptide (TRAP) (10 µmol/l) served as the platelet agonist (n = 21). *p < 0.01 vs. control.  p < 0.01 vs. pre-drug.
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Figure 4 Percentage of neutrophils with bound platelets (left panel) and number of platelets bound per neutrophil (right panel) in normal volunteers (control = no clopidogrel) and in acute coronary syndrome patients before and during clopidogrel, adenosine diphosphate (ADP) (10 µmol/l), or thrombin receptor agonist peptide (TRAP) (10 µmol/l) used as the platelet agonist (n = 21). *p < 0.01 vs. control. p < 0.01 vs. pre-drug.
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