The effects of coronary artery disease severity on time-dependent changes in platelet activation indices in stored whole blood
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Published on: November 8, 2024
Christopher J Boos1, Balu Balakrishnan, Gregory Y H Lip
1Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, B18 7QH, UK.
Insights
Platelet activation indices like MPV, MPC, and PCDW change over time when stored in EDTA tubes. These temporal changes in platelet markers are not affected by cardiovascular disease severity.
Area of Science:
- Hematology
- Cardiovascular Disease Research
- Biomarker Analysis
Background:
- Platelets are crucial in cardiovascular disease (CVD) pathogenesis.
- Platelet activation indices are emerging as CVD risk stratification markers.
- The impact of disease severity on temporal changes in these indices remains understudied.
Purpose of the Study:
- To investigate the effects of whole blood storage time on platelet activation indices.
- To determine if underlying cardiovascular disease severity influences these time-dependent changes.
Main Methods:
- Assessed mean platelet volume (MPV), mean platelet component (MPC), and platelet component distribution width (PCDW) using an ADVIA 120 analyser.
- Studied healthy controls, stable coronary artery disease (CAD) patients, and acute myocardial infarction (AMI) patients.
- Monitored changes in platelet indices over 120 minutes of whole blood storage at room temperature in EDTA tubes.
Main Results:
- MPV significantly increased and PCDW significantly decreased over storage time (P < 0.05).
- MPC showed a significant time-dependent decrease (P < 0.05).
- No significant interaction was found between underlying disease severity and time-dependent changes for any platelet index.
Conclusions:
- Temporal changes in MPV, MPC, and PCDW occur within 2 hours of whole blood storage in EDTA.
- These storage-related alterations in platelet indices are independent of cardiovascular disease severity.
Background:
Platelets play a pivotal role in the pathogenesis of the thrombotic complications in cardiovascular disease (CVD). Abnormal platelet activation indices are evolving as potentially useful markers in CVD risk stratification. Whilst there has been some investigation into the effects of storage time on several of these indices, the effects of underlying disease severity on these temporal changes have not been previously studied.
Methods:
Using the ADVIA 120 haematology analyser, we assessed the effects of time-dependent storage of whole blood in EDTA, on a number of platelet activation indices: mean platelet volume (MPV), mean platelet component (MPC, measure of platelet density) and platelet component distribution width (PCDW, a marker of platelet shape change. We studied three age- and sex-matched patient groups: (i) healthy controls (n = 10), (ii) stable patients with coronary artery disease (CAD, n = 9); and (iii) patients with acute myocardial infarction (n = 8). Whole blood samples were processed at exactly 5 min following venesection and at 15, 30, 60 and 120 min later in storage in EDTA tubes at room temperature.
Results:
There was a significant and stepwise increase in MPV (P = 0.01) and decrease in PCDW (P = 0.03), with a non-significant trend to increasing MPM and decreasing MPC with increasing underlying disease (that is healthy, 'stable' and 'acute' artery disease). There was a significant time-dependent increase in MPV and decrease in MPC and PCDW (all P < 0.05), which were all significant on 'post-hoc' analyses by 30 min. There were no significant changes in platelet count or MPM with time. There was no interaction of underlying disease with whole-blood storage time for any of the platelet indices reported (P = NS).
Conclusion:
There is a temporal increase in MPV and decrease in MPC and PCDW in venous blood stored over 2 h in EDTA. These changes are not influenced by the underlying CVD disease severity.
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