Clinical Predictors of the Level of Circulating Immature Platelets in Patients with Acute Coronary Syndrome

Adi Lador 1 Adaya Weissler-Snir 1 Aryeh Abelow 2 Doron Lederfein 3 Negba Hen Hanuka 3 Ran Kornowski 1 Eli Lev 1
1Cardiology Department, Rabin medical center, Beilinson Campus, Petah-Tikva
2Internal Medicine A, Rabin Medical Center, Beilinson Campus, Petah-Tikva
3Hematology laboratory, Rabin Medical Center, Hasharon campus, Petah-Tikva

Background: Platelets play a pivotal role in the development of atherothrombotic events and platelet hyper-reactivity is associated with adverse prognosis in patients with acute coronary syndromes (ACS). Immature platelets (IPs) are newly-formed platelets with high dense granules content, a residual amount of mRNA and increased mean volume compared to older circulating platelets. Detection of these platelets in the circulating blood reflects a high rate of platelet turnover. Recently an increased proportion of IPs has been reported to be independent predictor of cardiovascular death in ACS. There is limited data regarding clinical and demographic parameters that may affect the level of circulating IPs.

Objective: To examine the proportion of IPs in patients with ACS in relation to age, gender, diabetes and other demographic and clinical variables.

Methods: We recruited patients with ACS (ST-elevation MI or Non ST-elevation ACS). We measured IPs level for each patient after loading of anti-platelet drugs and performance of cardiac catheterization, by using an automated haemautoanalyzer. Immature platelet fraction (IPF) was expressed as the percentage of IPs out of the total optical platelet count. IPF was correlated with various clinical and demographic variables.

Results: We measured IPF in 165 patients with ACS (mean age = 65.5±12.6, 23% females, 57% STEMI, 43% NSTE-ACS). We found a significant correlation between diabetes status and IPF level, with diabetics having higher IPF levels compared with non-diabetics (3.6 vs. 2.5, P=0.0027). There was no correlation between other variables such as age type of ACS, smoking status, chronic renal failure, congestive heart failure, dyslipidemia or hypertension and the proportion of IPF.

Conclusion: In a population of patients with ACS, patients with diabetes had higher IPF levels than those without diabetes. Other clinical factors were not associated with the levels of IPF.









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