Direct evaluation of antiplatelet therapy in coronary artery disease by comprehensive image-based profiling of
Kazutoshi Hirose1, Satoshi Kodera1, Masako Nishikawa2
1Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Insights
Image-based profiling of circulating platelets offers a new way to monitor antiplatelet therapy for coronary artery disease (CAD). This method accurately assesses treatment efficacy and safety by measuring platelet aggregates in CAD patients.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Artificial Intelligence in Medicine
Background:
- Coronary artery disease (CAD) is a major global health concern, with antiplatelet therapy being vital for managing thrombotic risks.
- Current methods for assessing antiplatelet therapy efficacy and safety are indirect, necessitating improved diagnostic approaches.
- Bleeding risk is a significant side effect of antiplatelet drugs, highlighting the need for precise monitoring.
Purpose of the Study:
- To develop and validate a comprehensive image-based profiling method for circulating platelets to assess thrombotic conditions in CAD patients.
- To directly evaluate the efficacy and safety of antiplatelet therapy in coronary artery disease (CAD) patients.
- To explore the utility of venous blood sampling for monitoring antiplatelet therapy effectiveness.
Main Methods:
- Utilized deep learning-based analysis on whole blood samples from 207 coronary artery disease (CAD) patients.
- Developed image-based profiling to quantify circulating platelet aggregates.
- Compared platelet aggregate concentrations in patients with acute coronary syndrome versus chronic coronary syndrome and during different antiplatelet regimens.
Main Results:
- Elevated concentrations of circulating platelet aggregates were observed in CAD patients, particularly in acute coronary syndrome.
- Antiplatelet drug treatment led to a regimen-dependent reduction in circulating platelet aggregates, confirming therapy efficacy.
- Consistent platelet aggregate concentrations were found in both venous and arterial blood samples.
Conclusions:
- Image-based platelet profiling provides a direct method for assessing antiplatelet therapy efficacy in coronary artery disease (CAD).
- Venous blood can serve as a reliable indicator for monitoring antiplatelet therapy effectiveness, simplifying patient monitoring.
- This approach supports personalized antiplatelet therapy strategies for improved management of CAD patients.
Abstract:
Coronary artery disease (CAD) is a leading cause of death globally. Antiplatelet therapy remains crucial in preventing and treating CAD-associated thrombotic complications, but it concurrently amplifies the risk of bleeding. Unfortunately, traditional platelet function measurement methods cannot directly evaluate its efficacy and safety. Here we demonstrate comprehensive image-based profiling of circulating platelets to directly observe thrombotic conditions and assess antiplatelet therapy in CAD patients. Deep learning-based analysis of whole blood samples from 207 CAD patients revealed elevated concentrations of circulating platelet aggregates, especially in acute versus chronic coronary syndrome patients. It also indicated a regimen-dependent reduction in these concentrations upon treatment with antiplatelet drugs, thereby verifying the direct efficacy of the therapy. Notably, consistent concentrations of these aggregates were found in both venous and arterial blood, suggesting venous blood as a reliable therapy efficacy indicator, despite CAD's arterial nature. These findings support personalized and improved antiplatelet therapy in CAD management.
