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Published on: November 8, 2024
Impact of aging on immature platelet count and its relationship with coronary artery disease
Monica Verdoia1, Matteo Nardin1,2, Federica Negro1
1Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy.
Insights
Advanced age does not increase immature platelet count (IPC) in elderly patients. Higher IPC in older adults is linked to more severe coronary artery disease (CAD) lesions, but not overall prevalence or extent.
Area of Science:
- Cardiology
- Hematology
- Geriatrics
Background:
- Elderly patients present unique challenges in cardiovascular risk assessment.
- Platelet parameters, including immature platelet count (IPC), are increasingly recognized for their role in cardiovascular disease.
- Limited data exist on the specific impact of platelet parameters on cardiovascular risk in the elderly population.
Purpose of the Study:
- To investigate the relationship between chronological age and immature platelet count (IPC).
- To evaluate the impact of IPC on the prevalence and severity of coronary artery disease (CAD) in elderly patients.
- To determine if IPC can explain the higher cardiovascular risk observed in older individuals.
Main Methods:
- A cohort of 2236 consecutive patients undergoing coronary angiography was analyzed.
- Patients were categorized into elderly (age ≥ 75 years) and younger groups.
- Immature platelet count (IPC) was measured at admission; coronary angiography assessed CAD prevalence, extent, and lesion characteristics.
Main Results:
- No significant difference in mean IPC was found between elderly and younger patients.
- Advanced age was not an independent predictor of higher IPC.
- While IPC did not correlate with overall CAD prevalence or extent, higher IPC was associated with a greater rate of calcified and type C lesions in elderly patients.
Conclusions:
- Advanced age is not associated with an elevated immature platelet count (IPC).
- IPC does not appear to explain the increased prevalence or severity of coronary artery disease (CAD) in the elderly.
- Higher IPC in elderly patients may indicate a predisposition to more complex atherosclerotic lesions.
Abstract:
Despite the fact that elderly patients represent a prevalent and challenging population in the current practice, few data exist on the impact of platelet parameters on cardiovascular risk in these patients. Therefore, the aim of the present study was to evaluate the impact of age on the immature platelet count (IPC) and their relationship with CAD. We included a total of 2236 consecutive patients undergoing coronary angiography in a single center. Elderly patients (age ≥ 75 years) were 756 (33.7%). IPC was measured at admission. Elderly patients were more often females (p < .001), with lower BMI and prevalence of smokers (p < .001), and a more complex cardiovascular risk profile and coronary disease (p = .02). Platelet count decreased with aging (p = .05), whereas no difference in the mean IPC was found between patients < or ≥75 years. In fact, advanced age did not emerge as an independent predictor of IPC above III tertile (≥8.6*10^6/ml), (adjusted OR[95%CI] = 0.97[0.78-1.21], p = .79). When considering elderly patients according to tertiles values of IPC (<5.1,5.1-8.59; ≥8.6*10^6/ml), we found no impact of IPC on the prevalence of CAD (81.1% vs 84.5% vs 81.5%, p = .92; adjusted OR[95%CI] = 1.08[0.67-1.72], p = .75) and its extent (37.7% vs 34.5% vs 40.2%, p = .57; adjusted OR[95%CI] = 1.22[0.85-1.73], p = .28). However, we observed a higher rate of calcified and type C lesions in elderly patients with higher IPC (p = .03 and p < .001, respectively). Therefore, advanced age is not associated with higher immature platelet count and the prevalence and severity of CAD. Moreover, IPC does not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients.
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