Assoc. Prof. Priv.-Doz. Dr. Thomas Gremmel, FESC

Work address
Medical University of Vienna
Department of Internal Medicine II
Waehringer Guertel 18-20
1090 Vienna, Austria

Phone: +43 (0)1 40400 - 46700
E-Mail: thomas.gremmel@meduniwien.ac.at 

Know-how and research interests
My main area of interest is platelet and thrombosis research with a particular focus on the study of the effects of antiplatelet agents in patients with cardiovascular disease.

My research has included five areas:

1. Establishment of platelet function tests. In detail, together with my co-workers, I established the six most widely used platelet function tests at the Medical University of Vienna (Thromb Haemost 2009;101:333-339; Platelets 2011;22:188-195). These tests can be used to assess on-treatment platelet reactivity, and thereby allow the study of the effects of antiplatelet agents.
   
   
2. Identification of influencing factors for the response to antiplatelet therapy. We identified numerous influencing factors for the antiplatelet effects of aspirin and clopidogrel, e.g. genetic polymorphisms (Int J Cardiol 2013;166:126-131; Thromb Res 2012;119:616-622), age (J Thromb Haemost 2010;8:37-42), obesity (Transl Res 2013;161:421-429), inflammation (J Atheroscler Thromb 2013;20:630-645), chronic kidney disease (Nephrol Dial Transplant 2013;28:2116-2122) and concomitant pharmacological therapy (Heart 2010;96:179-180).
   
   
3. Evaluation of a therapeutic strategy in case of inadequate platelet inhibition by clopidogrel. We randomized patients with high on-treatment platelet reactivity despite clopidogrel therapy to two different treatment regimens (75mg vs. 150mg clopidogrel/day), and showed that the increase of clopidogrel maintenance dose increases its antiplatelet effects in poor responders (Int J Cardiol 2012;160:109-113).
   
   
4. Study of platelet activation and leukocyte-platelet interactions in patients with cardiovascular disease. For example, we demonstrated that in vivo and protease-activated receptor-1 mediated platelet activation is a strong predictor of subsequent adverse ischemic events in patients undergoing peripheral angioplasty and stenting (Thromb Haemost 2014;111:474-482). 
   
   
5. Development and investigation of new antiplatelet agents. We recently showed that a newly developed inhibitor of both platelet ADP receptors (P2Y1 and P2Y12) immediately attenuates platelet-mediated thrombosis and effectively blocks agonist-stimulated platelet aggregation irrespective of concomitant aspirin therapy. (Arterioscl Thromb Vasc Biol 2016;36:501-509).

Research topic

Platelet and thrombosis research in cardiovascular disease

Techniques and infrastructure of the research group

• Basic research laboratory with up-to-date methodology including flow cytometry, qPCR, light transmission aggregometry, multiple electrode aggregometry, cone and plate(let) analyzer, VerifyNow assays.
• Clinical research team with experience in clinical trials and advanced statistical techniques.
• National and international collaborations.

5 selected publications

• Gremmel T, Yanachkov IB, Yanachkova MI, Wright GE, Wider J, Undyala VV,  Michelson AD, Frelinger AL 3rd, Przyklenk K. Synergistic inhibition of both P2Y1  and P2Y12 adenosine diphosphate receptors as novel approach to rapidly  attenuate platelet-mediated thrombosis. Arterioscler Thromb Vasc Biol  2016;36:501-509.
  
  
• Uderhardt S, Ackermann JA, Fillep T, Hammond VJ, Willeit J, Santer P, Mayr M, Biburger M, Miller M, Zellner KR, Stark K, Zarbock A, Rossaint J, Schubert I, Mielenz D, Dietel B, Raaz-Schrauder D, Ay C, Gremmel T, Thaler J, Heim C, Herrmann M, Collins PW, Schabbauer G, Mackman N, Voehringer D, Nadler JL, Lee JJ, Massberg S, Rauh M, Kiechl S, Schett G, O’Donnell VB, Krönke G. Enzymatic lipid oxidation by eosinophils propagates coagulation, hemostasis and thrombotic disease. J Exp Med 2017;214:2121-2138.
  
  
• Lee S, Ay C, Kopp CW, Panzer S, Gremmel T. Impaired glucose metabolism  is associated with increased thrombin generation potential in patients  undergoing angioplasty and stenting. Cardiovasc Diabetol 2018;17:131.
  
  
• Gremmel T, Steiner S, Seidinger D, Koppensteiner R, Panzer S, Kopp CW. In vivo and protease-activated receptor-1-mediated platelet activation but not response to antiplatelet therapy predict 2-year outcomes after peripheral angioplasty with stent implantation. Thromb Haemost 2014;111:474-482.
  
  
• Gremmel T, Steiner S, Seidinger D, Koppensteiner R, Panzer S, Kopp CW. Adenosine diphosphate-inducible platelet reactivity shows a pronounced age dependency in the initial phase of antiplatelet therapy with clopidogrel. J Thromb Haemost 2010;8:37-42.