Enhanced platelet reactivity and thrombosis in Apoe-/- mice exposed to cigarette smoke is attenuated by P2Y12 antagonism

Anping Dong, Jessica Caicedo, Sung Gu Han, Paul Mueller, Sibu Saha, Susan S. Smyth, C. Gary Gairola

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Introduction: Smoking increases the risk of acute arterial thrombosis, including myocardial infarction, likely due to multi-factorial effects on the vasculature. Heightened platelet reactivity may be among the adverse effects of smoke exposure. Methods: To examine the effects of smoke exposure on platelet function in an atherosclerotic environment, Apoe-deficient female mice, maintained on a Western diet, were exposed (4 hrs/d, 5d/wk) to sidestream cigarette smoke in a whole-body exposure chamber for12 weeks. A separate group of wild type C57BL/6 J mice were also exposed to smoke in an identical fashion. Results: In comparison to control Apoe-/- mice exposed to filtered ambient air, smoke-exposed Apoe-/- mice displayed a 1.8 ± 0.3 fold enhanced ADP-induced fibrinogen binding ex vivo (P < 0.001) and had a shorter time to thrombotic occlusion following ferric chloride injury of the carotid artery (median time to thrombosis of 8 vs. 13 min; P = 0.015). Administration of the direct-acting P2Y12 antagonist cangrelor blunted ex vivo fibrinogen binding and attenuated thrombosis (median time 20 min) in Apoe-/- mice exposed to sidestream smoke. The effects of smoke exposure required a proatherosclerotic background, as wild-type C57Bl/6 J mice exposed to smoke displayed similar fibrinogen binding and thrombotic occlusion times as did control mice. Conclusions: Our results demonstrate that exposure to smoke heightens platelet reactivity and thrombosis in Apoe-/- mice and implicate signaling through platelet P2Y12 receptor as a mediator of the adverse consequence of smoke exposure. These results may partially explain the recent observations that smokers derive greater clinical benefit from the P2Y12 antagonist clopidogrel than do non-smokers.

Original languageEnglish
Pages (from-to)e312-e317
JournalThrombosis Research
Issue number4
StatePublished - Oct 2010

Bibliographical note

Funding Information:
The authors wish to express their appreciation for the excellent technical assistance provided by Ruth Holland. This material is the result of work supported with resouces and the use of facilities at the Lexington VA Medical Center. This work was supported by NIH grants HL078663, HL0870166, and HL074219 to S.S.S and by funds from the University of Kentucky Cardiothoracic Surgery Division. We thank The Medicines Company for their generous gift of cangrelor.

Funding Information:
Dr. Smyth is the current recipient of an investigator-initiated research grant from The Medicines Company for an unrelated project. None of the other authors have conflicts to report.


  • Apoe
  • Cigarette smoking
  • P2Y12
  • Thrombosis

ASJC Scopus subject areas

  • Hematology


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