Background: Oxidized phospholipids (OxPL) on plasminogen (OxPL-PLG) are associated with reduced time to fibrinolysis and lower risk of cardiovascular outcomes, but it is not known if they influence platelet function.
Objectives: To evaluate the association of OxPL-PLG with intrinsic and on‑clopidogrel platelet reactivity and long-term cardiovascular events.
Methods: OxPL-PLG was measured in 2040 patients undergoing elective coronary angiography with or without percutaneous coronary angiography (PCI) if indicated in the EXCELSIOR trial. The association of OxPL-PLG to intrinsic and on-clopidogrel platelet reactivity and platelet surface expression of CD62P, CD41 and PAC-1 levels and to myocardial infarction(MI)-free survival and all-cause mortality at a median of 7 years using multivariable Cox regression models was determined.
Results: Elevated levels of OxPL-PLG were inversely and significantly associated with age, male sex, previous MI, PCI, and CABG, and positively will LDL-C, hypertension and obesity, plasminogen levels, platelet count and higher LV function. A significant association were present between OxPL-PLG and intrinsic platelet reactivity in response to ADP (p<0.001) but not collagen (p=0.085). OxPL-PLG was inversely and significantly associated with CD41 (p<0.001), CD62P (p<0.001), PAC-1 (p<0.001) platelet surface expression at baseline and with CD41 (p<0.001), CD62P (p=0.020), after 24 hours but not PAC-1 (p=0.058), p-values for linear relationship. OxPL-PLG and plasminogen were not associated with all-cause of MI-free survival at median 7-year follow-up.
