Contemporary Reviews in Interventional Cardiology Cardiovascular Devices and Platelet Interactions Understanding the Role of Injury, Flow, and Cellular Responses

The objectives of the 2011 Platelet Colloquium were to gain a better understanding of the role of platelets and inflammatory cells in the response to cardiovascular device– associated injury; to describe the relationship between cardiac devices, shear stress, and alterations in platelet biology and function; and to review evidence derived from in vitro, in vivo, and clinical investigations supporting therapies to modify platelet and inflammatory cell–associated responses to device-related injury. Accordingly, this review summarizes the evidence for translating basic scientific concepts underlying circulatory and device-associated vascular injury to the clinical development and use of cardiac devices, supplemented by findings from the literature. Insights for platelet receptor activation, inflammatory cell biology, endothelial dysregulation, and the effects of biomechanical stress on coagulation and hemostatic proteins were examined to better determine the pathobiology, incidence, and possible prevention of adverse events in patients receiving cardiac devices.