Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

IF 3.4 3区 医学 Q2 HEMATOLOGY
Oliver Buchhave Pedersen , Peter H. Nissen , Leonardo Pasalic , Anne-Mette Hvas , Steen Dalby Kristensen , Erik Lerkevang Grove
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Abstract

Background

Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets.

Objectives

To investigate changes in platelet maturity and reactivity after acute STEMI.

Methods

Patients diagnosed with STEMI, admitted for primary percutaneous coronary intervention, and treated according to international guidelines, were included. Blood samples were obtained within 24 hours after admission and at 2- to 3-months follow-up. Platelet maturity and reactivity using multicolor flow cytometry with SYTO-13 to categorize platelet maturity, whole blood platelet aggregation, serum thromboxane B2 levels, and standard immature platelet markers (eg, immature platelet count and fraction, and mean platelet volume) were measured.

Results

A total of 44 STEMI patients were included. The reactivity of immature platelets was consistently higher at baseline and at follow-up when compared to the entire platelet population and the mature platelet population (all P values < .05). The expression of CD63 (a dense granule marker) in immature platelets was consistently high compared to the entire platelet population and the mature platelet population and did not change from baseline to follow-up (P values > .24). Additionally, a positive significant correlation was found between standard immature platelet markers and the expression of CD63 on platelets both at baseline and follow-up (rho ranging from 0.32 to 0.62, all P values < .05).

Conclusion

Immature platelets represent a highly reactive platelet subpopulation crucial for the overall platelet reactivity, partly due to a high expression of dense granules. Despite treatment with loading and maintenance doses of antiplatelet therapy, the reactivity of immature platelets remained high in STEMI patients.

Abstract Image

急性st段抬高型心肌梗死后血小板成熟度和反应性的变化。
背景:有报道称st段抬高型心肌梗死(STEMI)患者抗血小板治疗效果降低。这可以部分解释为高反应性未成熟血小板的增加。目的:探讨急性STEMI后血小板成熟度和反应性的变化。方法:纳入诊断为STEMI、接受经皮冠状动脉介入治疗并按照国际指南治疗的患者。入院后24小时内及2 ~ 3个月随访时采集血样。采用SYTO-13多色流式细胞仪对血小板成熟度、全血血小板聚集、血清血栓素B2水平和标准未成熟血小板标志物(如未成熟血小板计数和分数、平均血小板体积)进行分类,测定血小板成熟度和反应性。结果:共纳入44例STEMI患者。在基线和随访时,未成熟血小板的反应性始终高于整个血小板群和成熟血小板群(均P值< 0.05)。与整个血小板群和成熟血小板群相比,未成熟血小板中CD63(一种致密颗粒标志物)的表达始终较高,并且从基线到随访没有变化(P值bb0.24)。此外,在基线和随访时,发现标准未成熟血小板标志物与血小板上CD63的表达呈正相关(rho范围为0.32 ~ 0.62,P值均< 0.05)。结论:未成熟血小板是一种高度反应性的血小板亚群,对血小板的整体反应性至关重要,部分原因是致密颗粒的高表达。尽管接受了负荷和维持剂量的抗血小板治疗,STEMI患者中未成熟血小板的反应性仍然很高。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.60
自引率
13.00%
发文量
212
审稿时长
7 weeks
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