Immature platelets in patients with acute coronary syndromes

Erik Lerkevang Grove; Anne-Mette Hvas; Steen Dalby Kristensen

doi:10.1160/TH08-03-0186

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2009; 101(01): 151-153
DOI: 10.1160/TH08-03-0186

Cardiovascular Biology and Cell Signalling

Schattauer GmbH

Immature platelets in patients with acute coronary syndromes

Authors

Erik Lerkevang Grove

¹Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark
Anne-Mette Hvas

²Department of Clinical Biochemistry, Centre for Haemophilia and Thrombosis, Aarhus University Hospital Skejby, Aarhus N, Denmark
Steen Dalby Kristensen

¹Department of Cardiology, Aarhus University Hospital Skejby, Aarhus N, Denmark

Abstract

Summary

Platelets newly released from the bone marrow are RNA-containing and more haemostatically active than mature platelets. Immature platelets are reliably quantified by flow cytometry, and the immature platelet fraction (IPF) reflects platelet production and the rate of platelet turnover. It was the objective of this study to evaluate the presence of immature platelets in healthy subjects, patients with stable coronary artery disease (CAD) and patients with acute coronary syndromes. Flow cytometric determination of immature platelets was performed with an automated analyzer (Sysmex XE-2100) using RNA fluorescent dyes. IPF was determined in 420 individuals: 22 healthy subjects, 39 patients with stable CAD, 182 patients with unstable angina/ non-ST-segment elevation myocardial infarction (non-STEMI) and 177 patients with acute STEMI. The geometric mean [95% confidence interval] of IPF was 2.51 [2.04–3.10] in healthy subjects, 2.87 [2.45–3.36] in CAD patients, 2.93 [2.72–3.15] in the non-STEMI/unstable angina group and 3.71 [3.45–3.99] in patients with STEMI (ANOVA: p < 0.0001). This difference remained significant after adjusting for baseline characteristics (p = 0.0003). In active smokers, IPF was 18% higher than in non-smoking individuals (p = 0.007), and IPF was 16% higher in diabetics compared with non-diabetics (p = 0.060). In conclusion, the fraction of immature platelets is increased in acute coronary syndromes, especially in the acute phase of STEMI. Immature platelets with an increased haemostatic potential may contribute to coronary thrombus formation.

Keywords

Atherothrombosis - arterial thrombosis - aspirin resistance - myocardial infarction - thrombopoiesis

Full Text

References

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