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Platelet turnover predicts outcome after coronary intervention

Matthias K Freynhofer1, Liana Iliev, Veronika Bruno

  • 1Matthias K. Freynhofer, MD, 3rd Department of Medicine, Cardiology, Wilhelminen Hospital, Montleartstraße 37, A-1160, Vienna, Austria, Tel.: +43 1 49150 2301, Fax: +43 1 49150 2309,

Thrombosis and Haemostasis
|February 24, 2017
PubMed

Insights

Elevated platelet turnover, indicated by reticulated platelet fraction (RPF), predicts major adverse cardiovascular events (MACE) and bleeding in patients undergoing percutaneous coronary intervention (PCI). RPF is a valuable tool for cardiovascular risk prediction in these patients.

Area of Science:

  • Cardiology
  • Hematology
  • Biomarkers

Background:

  • High platelet reactivity after percutaneous coronary intervention (PCI) is linked to major adverse cardiovascular events (MACE).
  • Elevated platelet turnover is a known contributor to increased platelet reactivity.

Purpose of the Study:

  • To evaluate the prognostic significance of platelet turnover and function for MACE after PCI with stent implantation.
  • To determine if reticulated platelet fraction (RPF) and mean platelet volume (MPV) predict MACE.

Main Methods:

  • A prospective observational study included 486 patients post-PCI on dual antiplatelet therapy (aspirin and clopidogrel).
  • Platelet turnover was assessed using MPV and RPF.
  • Platelet function was measured by multiple electrode aggregometry (MEA) and vasodilator-stimulated phosphoprotein-phosphorylation (VASP-P) assay.
  • Major adverse cardiovascular events (MACE) and in-hospital bleeding were recorded at six-month follow-up.

Main Results:

  • RPF and MPV were univariable predictors of MACE.
  • RPF emerged as the sole platelet variable independently associated with MACE.
  • A predictive model for MACE included troponin I, RPF, C-reactive protein (CRP), and a history of myocardial infarction.
  • RPF was also independently associated with in-hospital bleeding events.

Conclusions:

  • Reticulated platelet fraction (RPF) serves as an independent predictor of MACE and bleeding in patients on dual antiplatelet therapy post-PCI.
  • RPF can be easily quantified via routine blood counts, suggesting its potential utility in cardiovascular risk stratification.

Keywords:
MultiplateReticulated plateletsVASP-Pdual antiplatelet therapymean platelet volume

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