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J Thorac Cardiovasc Surg 2003;126:1101-1106
© 2003 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Generation of platelet-derived microparticles in patients undergoing cardiac surgery is not affected by complement activation

Jeanette M. van den Goor, MSc, CPa,*, Albert van den Brink, MDa, Rienk Nieuwland, PhDc, Willem van Oeveren, PhDe, Peter M. Rutten, CPa, Robert Tepaske, MDb, Jan G. Tijssen, PhDd, Augueste Sturk, PhDc, Bas A. de Mol, MD, PhDa, León Eijsman, MD, PhDa

a Department of Cardio-thoracic Surgery, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
b Department of Intensive Care,, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
c Department of Clinical Chemistry,, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
e Department ofCardiology, Academic Medical Center of the University of Amsterdam, Amsterdam, The Netherlands
e HaemoProbe, Groningen, The Netherlands

Received for publication December 20, 2002; revisions received January 21, 2003; revisions received February 17, 2003; accepted for publication June 16, 2003.

* Address for reprints: Jeanette M. van den Goor, MSc, CP, Department of Cardio-thoracic Surgery, Academic Medical Center of the University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
J.M.vandenGoor{at}AMC.UVA.nl

OBJECTIVE: The mechanisms causing the presence of platelet-derived microparticles in the circulation are unknown. In vitro platelets release platelet-derived microparticles in response to complement activation. This study evaluates the relationship between complement activation and levels of circulating platelet-derived microparticles in patients undergoing cardiac surgery.

METHODS: Prospectively, 71 patients were included who underwent elective coronary artery bypass grafting with cardiopulmonary bypass. The patients were randomly allocated to one of the 3 groups: uncoated oxygenator, UnModified Surface (n = 25) or oxygenator coated with either BioPassive Surface (n = 25) or BioActive Surface (n = 21). Platelet-derived microparticles and terminal complement complexes were determined before bypass and after induction of anesthesia, 15 minutes after the start of cardiopulmonary bypass, at the end of cardiopulmonary bypass, and 30 minutes after administration of protamine sulfate.

RESULTS: Demographic and cardiopulmonary bypass data were similar for the 3 groups. At the end of cardiopulmonary bypass, platelet-derived microparticle numbers were decreased in all 3 groups. No significant differences were observed among the groups at any sampling point. At the end of cardiopulmonary bypass, terminal complement complex concentrations were increased in all groups (P < .001), and significant differences among the groups were present (P = .002).

CONCLUSIONS: Despite significant complement activation, no increase in numbers of circulating platelet-derived microparticles was found in the systemic blood of patients undergoing cardiac surgery with cardiopulmonary bypass. Thus complement activation in vivo does not necessarily affect generation of platelet-derived microparticles.




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