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Change in Platelet Lipid Metabolism and Procoagulant Phenotype Induced by Cardiopulmonary Bypass. Impact on Postoperative Inflammatory Response and Bleeding Complications During Cardiac Surgery. (PLACARD)

2 juni 2026 uppdaterad av: Université Catholique de Louvain
The PLACARD research project aims to investigate the impact of CPB-induced platelet modifications during cardiac surgery on the post-operative inflammatory response and bleeding complications. Our objectives are to study the impact of CPB on the formation of procoagulant platelets, to assess changes in platelet lipid profile and bioenergetics before, during and after cardiac surgery, and to connect the ex-vivo observations to post-operative clinical and biological parameters of these patients during their stay in cardiovascular intensive care unit.

Studieöversikt

Status

Har inte rekryterat ännu

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Cardiac surgery remains associated with high morbidity and mortality despite improvements in peri and post-operative care. Cardiopulmonary bypass (CPB) triggers a sterile inflammatory response, characterized by vascular hyperpermeability, excessive vasodilation, and cardiac arrythmias, i.e. atrial fibrillation. In parallel, major peri-operative bleeding frequently necessitates transfusion of allogeneic blood products. The pathophysiology underlying these complications is multifactorial. Direct contact of blood with the CPB tubing system, combined with ischemia-reperfusion injury, profoundly alters both the inflammatory and haemostatic systems. Among blood components, platelets are particularly vulnerable to CPB-induced alterations. Platelet dysfunction is widely recognized as the main haemostatic defect associated with CPB and a major contributor to post-operative bleeding. Recent findings have demonstrated that platelet lipid metabolism plays a key role in regulating thrombo-inflammatory responses in sepsis. These observations raise the hypothesis that CPB-induced alterations in platelet lipid metabolism may critically modulate the balance between inflammation and haemostasis in cardiac surgery.

The PLACARD project therefore aims to investigate how CPB-induced platelet modifications influence post-operative inflammatory responses and bleeding complications.

Specific objectives:

  1. Characterize the impact of CPB on the formation of procoagulant platelets.
  2. Assess changes in platelet lipid composition and bioenergetics before, during and after cardiac surgery.
  3. Correlate ex-vivo platelet alterations with post-operative clinical outcomes and biological markers during the stay in the cardiovascular intensive care unit.

This project addresses a critical unmet need in cardiac surgery: understanding the mechanistic link between CPB-induced platelet dysfunction and thrombo-inflammatory complications. By focusing on platelet lipid metabolism, a pathway largely unexplored in this context, the project moves beyond traditional platelet function assays. The results are expected to provide fundamental mechanistic insights into procoagulant platelet formation during CPB and may identify novel biomarkers or therapeutic targets to reduce bleeding and inflammatory complications in high-risk surgical patients.

Studietyp

Interventionell

Inskrivning (Beräknad)

100

Fas

  • Inte tillämpbar

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studiekontakt

Studera Kontakt Backup

Studieorter

  • Belgien
      • Brussels, Belgien, 1200
        • Cliniques Universitaires Saint-luc
        • Kontakt:
        • Kontakt:
        • Underutredare:
          • Richard Coulie, MD
        • Underutredare:
          • Mona Momeni, MD, PhD
        • Huvudutredare:
          • Christophe Beauloye, MD, PhD

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

  • Vuxen
  • Äldre vuxen

Tar emot friska volontärer

Nej

Beskrivning

Inclusion Criteria:

  • Adult patients (≥ 18 years old) suffering from coronary disease and/or severe valvular dysfunction (mitral or aortic) undergoing elective coronary angiography or cardiac surgery with cardiopulmonary bypass.

Exclusion Criteria:

  • Uninterrupted preoperative dual antiplatelet therapy
  • Active chronic inflammatory disease
  • Recent chemotherapy or immunotherapy (< 3 months)
  • Active solid malignancy
  • History of hematologic malignancy
  • Hemophilia or other coagulopathy
  • History of thrombocytopenia (< 100,000 platelets/mm³)
  • Recent administration of thrombopoietin receptor agonist or immunoglobulins
  • History of thrombopathy, thrombocytosis, or myeloproliferative syndrome
  • History of heparin-induced thrombocytopenia (HIT)
  • Cirrhosis or hepatic fibrosis (with or without hypersplenism)
  • History of splenectomy, regardless of initial indication
  • History of systemic autoimmune disease (e.g., systemic lupus erythematosus, scleroderma, antiphospholipid syndrome, systemic vasculitis)
  • Recent major surgery (< 3 months)
  • Severe renal insufficiency (eGFR ≤ 30 mL/min/m²) with or without dialysis
  • Recent or chronic corticosteroid therapy
  • Recent acute coronary syndrome, STEMI type (< 3 months)
  • Urgent surgery or procedure
  • Preoperative hemodynamic instability

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Grundläggande vetenskap
  • Tilldelning: Icke-randomiserad
  • Interventionsmodell: Parallellt uppdrag
  • Maskning: Ingen (Open Label)

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Cathlab patients
This group includes patients with coronary disease and/or valvular disease scheduled for elective coronary angiography.
Biologisk: Arterial blood sample
An arterial blood sample will be obtained at the beginning of the coronary angiography by using the arterial sheat in place, before administration of Heparin.
Biologisk: Arterial blood sample
An arterial blood sample will be obtained via the arterial line before anesthetic induction, 60 minutes after the beginning of cardiopulmonary bypass and 4 hours after the arrival in the intensive care unit
Experimentell: Cardiac surgery patients
This arm includes patients with coronary disease and/or valvular disease scheduled for elective cardiac surgery with cardiopulmonary bypass.
Biologisk: Arterial blood sample
An arterial blood sample will be obtained at the beginning of the coronary angiography by using the arterial sheat in place, before administration of Heparin.
Biologisk: Arterial blood sample
An arterial blood sample will be obtained via the arterial line before anesthetic induction, 60 minutes after the beginning of cardiopulmonary bypass and 4 hours after the arrival in the intensive care unit

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Procoagulant platelet formation
Tidsram: Throughout the entire study, approximately during 32 months
Ex-vivo flow cytometric assessment of the pourcentage of procoagulant platelet population under basal and stimulated conditions.
Throughout the entire study, approximately during 32 months

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Platelet lipidomics
Tidsram: Throughout the entire study, approximately during 32 months
Assessment of the impact of cardiac surgery and cardiopulmonary bypass on platelet lipid metabolism. Pourcentage of patients with platelet Acety-CoA Carboxylase phosphorylation.
Throughout the entire study, approximately during 32 months
Postoperative bleeding
Tidsram: Throughout the entire study, approximately during 32 months
Correlation between the ex-vivo primary outcomes and clinical postoperative parameters (chest drain output (mL) and need for blood transfusion (units of packed red cells, fresh frozen plasma, platelets and fibrinogen)).
Throughout the entire study, approximately during 32 months
Postoperative inflammation
Tidsram: Throughout the entire study, approximately during 32 months
Correlation between the ex-vivo primary outcomes and biological postoperative parameters (C-reactive protein).
Throughout the entire study, approximately during 32 months
Postoperative platelet function
Tidsram: Throughout the entire study, approximately during 32 months
Correlation between the ex-vivo primary outcomes and biological postoperative parameters (platelet aggregometry results).
Throughout the entire study, approximately during 32 months
Postoperative coagulation
Tidsram: Throughout the entire study, approximately during 32 months
Correlation between the ex-vivo primary outcomes and biological postoperative parameters (thromboelastography and standard coagulation results (INR, aPTT, Fibrinogen)).
Throughout the entire study, approximately during 32 months

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Université Catholique de Louvain

Samarbetspartners

Fonds National de la Recherche Scientifique
Fondation Mont-Godinne

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Beräknad)

15 maj 2026

Primärt slutförande (Beräknad)

1 januari 2029

Avslutad studie (Beräknad)

1 januari 2030

Studieregistreringsdatum

Först inskickad

7 maj 2026

Först inskickad som uppfyllde QC-kriterierna

2 juni 2026

Första postat (Faktisk)

5 juni 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

5 juni 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

2 juni 2026

Senast verifierad

1 juni 2026

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • PLACARD

Plan för individuella deltagardata (IPD)

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