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Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Baseline platelet count and clinical outcome in acute coronary syndrome
Yihua Wu1, Han Wu, Christian Mueller
1Department of Medicine, Zhejiang University, Hangzhou, China.
Insights
Higher platelet counts (PLT) in acute coronary syndrome (ACS) patients are linked to increased mortality and major adverse cardiac events (MACE). This finding highlights PLT as a significant prognostic indicator in ACS.
Area of Science:
- Cardiology
- Hematology
- Clinical Research
Background:
- The independent association between platelet count (PLT) and clinical outcomes in acute coronary syndrome (ACS) patients remains unclear.
- Understanding this relationship is crucial for risk stratification and management of ACS.
Purpose of the Study:
- To investigate the independent association between baseline platelet count (PLT) and clinical outcomes, including mortality and major adverse cardiac events (MACE), in patients with acute coronary syndrome (ACS).
Main Methods:
- A systematic literature search was conducted across multiple databases (MEDLINE, EMBASE, Cochrane library, etc.) to identify relevant studies.
- Eight studies comprising 39,324 patients were included, focusing on PLT quantification and its association with MACE and mortality.
- Data on study design, participant characteristics, PLT levels, clinical outcomes, and risk estimates were independently abstracted and pooled.
Main Results:
- At 1-month follow-up, patients with high PLT (> 350 × 10(9)/L) showed significantly increased pooled relative risks (RR) for MACE (1.63, P<0.001) compared to those with low PLT (< 150 × 10(9)/L).
- Long-term follow-up (≥ 1 year) revealed elevated pooled RRs for both mortality (1.48, P=0.02) and MACE (1.28, P=0.02) in patients with high PLT.
- When analyzed as a continuous variable, PLT demonstrated a significant pooled RR of 1.024 (P=0.03) for longitudinal mortality.
Conclusions:
- Elevated baseline platelet count (PLT) is independently associated with an increased risk of mortality and major adverse cardiac events (MACE) in patients diagnosed with acute coronary syndrome (ACS).
- PLT serves as a significant prognostic biomarker in ACS, warranting consideration in clinical risk assessment.
Background:
It is unclear whether platelet count (PLT) is independently associated with clinical outcome in patients with acute coronary syndrome (ACS).
Methods And Results:
MEDLINE, EMBASE, the Cochrane library clinical trials registry, ISI Science Citation Index, and ISI Web of Knowledge were searched, supplemented by hand-scanning of references of relevant publications and contacting content experts. Eight studies including 39,324 patients were identified that addressed the following issues: major adverse cardiac events (MACE) and mortality were defined as endpoints; the relative risk (RR) or relative odds and their variance with MACE associated with PLT; studies in which only PLT was quantified. Two investigators independently abstracted information on study design, study and participant characteristics, PLT, clinical outcomes, control for potential confounding factors and risk estimates using a standardized protocol. At 1-month follow-up, compared with the bottom PLT group (< 150 × 10(9)/L), the pooled RRs of mortality and MACE were 1.78 (P=0.14) and 1.63 (P<0.001) for the upper PLT (> 350 × 10(9)/L), respectively. At long-term follow-up (≥ 1 year), the pooled RRs of mortality and MACE were 1.48 (P=0.02) and 1.28 (P=0.02) for the upper PLT, respectively. Moreover, the pooled RR of longitudinal mortality was 1.024 (P=0.03) when PLT was used as a continuous variable.
Conclusions:
Higher PLT at baseline increases the RR of mortality and MACE in ACS patients.
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