{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:37:44Z","timestamp":1760150264203,"version":"build-2065373602"},"reference-count":40,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T00:00:00Z","timestamp":1698537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"IRONHEART","award":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"]}]},{"name":"Hungarian Research Fund","award":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"]}]},{"name":"New National Excellence Program","award":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"],"award-info":[{"award-number":["GINOP-2.3.2-15-2016-00043","FK 135327","\u00daNKP-22-4-II-DE-120"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Percutaneous coronary intervention (PCI) is a frequently performed treatment option for recanalization in patients with chronic total occlusion (CTO). As CTO-PCIs are often complicated and challenging for interventionalists, the stressful and damaging nature of the procedure can be remarkable, thus platelets can be easily activated. Our aim was to investigate the effect of CTO-PCI on platelet activation and the expression of selected circulating microRNAs (miR) of platelet and endothelium origin after CTO-PCI. In this study, 50 subjects after CTO-PCI were enrolled. Blood samples were obtained before PCI, at 2 days and 3\u20136 months after the procedure to measure the degree of platelet activation and the level of plasma miR-223, miR-181b, and miR-126. Patients were divided based on the characteristics of the intervention. Patients with higher Japanese CTO scores and longer duration of PCI showed significantly elevated platelet P-selectin positivity (p = 0.004 and p = 0.013, respectively) 2 days after the procedure compared to pre-PCI and increased concentration of soluble P-selectin 3\u20136 months after the intervention (higher Japanese CTO score: p = 0.028 and longer duration of PCI: p = 0.023) compared to baseline values. Shorter total stent length caused a significantly lower miR-181b expression at 3\u20136 months after the intervention (p = 0.031), while no difference was observed in miR-223 and miR-126. One stent thrombosis occurred during the follow-up period. Although these technically challenging CTO-PCIs may cause enhanced platelet activation right after the intervention and long-term endothelial cell dysfunction, these interventions are not associated with more adverse clinical events.<\/jats:p>","DOI":"10.3390\/jcm12216829","type":"journal-article","created":{"date-parts":[[2023,10,29]],"date-time":"2023-10-29T05:01:08Z","timestamp":1698555668000},"page":"6829","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Technically Challenging Percutaneous Interventions of Chronic Total Occlusions Are Associated with Enhanced Platelet Activation"],"prefix":"10.3390","volume":"12","author":[{"given":"\u00c1d\u00e1m","family":"Ill\u00e9si","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of K\u00e1lm\u00e1n Laki, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1387-2970","authenticated-orcid":false,"given":"Zsolt","family":"Fejes","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"P\u00f3csi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ildik\u00f3 Beke","family":"Debreceni","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katalin","family":"Hodosi","sequence":"additional","affiliation":[{"name":"Institute of Internal Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-3267","authenticated-orcid":false,"given":"B\u00e9la","family":"Nagy Jr.","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00e1nos","family":"Kappelmayer","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2817-6900","authenticated-orcid":false,"given":"Zsolt","family":"K\u0151szegi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of K\u00e1lm\u00e1n Laki, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Andr\u00e1s J\u00f3sa University Teaching Hospital, 4400 Nyiregyhaza, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zolt\u00e1n","family":"Csan\u00e1di","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of K\u00e1lm\u00e1n Laki, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tibor","family":"Sz\u00fck","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"},{"name":"Doctoral School of K\u00e1lm\u00e1n Laki, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e006732","DOI":"10.1161\/JAHA.117.006732","article-title":"Chronic Total Occlusion Percutaneous Coronary Intervention: Evidence and Controversies","volume":"7","author":"Tajti","year":"2018","journal-title":"J. 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