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Impact of Long-Term Dual Antiplatelet Therapy on Immature Platelet Count and Platelet Reactivity

Monica Verdoia1, Patrizia Pergolini2, Roberta Rolla2

  • 11 Division of Cardiology, Azienda Ospedaliera-Universitaria "Maggiore della Carità", Eastern Piedmont University, Novara, Italy.

Angiology
|October 31, 2017
PubMed

Insights

Immature platelet count (IPC) can indicate platelet reactivity during dual antiplatelet therapy (DAPT). An increased IPC suggests lower platelet drug effectiveness, particularly with ADP antagonists.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Immature platelet count (IPC) is a potential indicator of platelet production and reactivity.
  • Dual antiplatelet therapy (DAPT) is crucial in managing cardiovascular diseases, but individual responses vary.
  • Understanding markers of platelet reactivity can optimize antiplatelet treatment efficacy.

Purpose of the Study:

  • To investigate the relationship between immature platelet count (IPC) and platelet reactivity in patients on chronic dual antiplatelet therapy (DAPT).
  • To assess if IPC changes correlate with the effectiveness of antiplatelet agents like aspirin, clopidogrel, and ticagrelor.

Main Methods:

  • A cohort of 286 patients receiving chronic DAPT (aspirin plus clopidogrel or ticagrelor) was studied.
  • Immature platelet count (IPC) and platelet reactivity were measured using arachidonic acid, collagen, and adenosine diphosphate (ADP) tests.
  • Changes in IPC (%ΔIPC) were analyzed in relation to antiplatelet drug type and overall platelet reactivity.

Main Results:

  • An increase in IPC was observed in patients treated with ticagrelor, while a decrease was seen with clopidogrel.
  • Lower platelet reactivity, as measured by various tests, was inversely associated with a higher increase in IPC.
  • Poor effectiveness of ADP antagonists was identified as an independent predictor of a significant increase in IPC.

Conclusions:

  • In patients on chronic DAPT, an elevated immature platelet count (IPC) is significantly linked to reduced platelet reactivity.
  • IPC may serve as a valuable biomarker to monitor antiplatelet therapy response and guide treatment adjustments.
  • The findings highlight the differential impact of clopidogrel and ticagrelor on IPC and suggest IPC's role in assessing antiplatelet drug effectiveness.

Keywords:
dual antiplatelet therapyimmature platelets fractionplatelet reactivity

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