Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy
Objective: Platelets are strongly associated with cardiovascular events due to their role in thrombotic processes. Reticulated platelets have higher prothrombotic potential. The aim of the study was to evaluate the effectiveness of immature platelet fraction (IPF) in predicting long-term clinical ou...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-01-01
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| Series: | Journal of Cardiovascular Pharmacology and Therapeutics |
| Online Access: | https://doi.org/10.1177/10742484231202864 |
| _version_ | 1797359574070591488 |
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| author | Karolina Gumiężna MD Piotr Baruś MD Grażyna Sygitowicz PhD Agnieszka Wiśniewska PhD Adrian Bednarek MS Jakub Zabłocki MS Adam Piasecki MS Dominika Klimczak-Tomaniak MD, PhD Janusz Kochman MD, PhD Marcin Grabowski MD, PhD Mariusz Tomaniak MD, PhD |
| author_facet | Karolina Gumiężna MD Piotr Baruś MD Grażyna Sygitowicz PhD Agnieszka Wiśniewska PhD Adrian Bednarek MS Jakub Zabłocki MS Adam Piasecki MS Dominika Klimczak-Tomaniak MD, PhD Janusz Kochman MD, PhD Marcin Grabowski MD, PhD Mariusz Tomaniak MD, PhD |
| author_sort | Karolina Gumiężna MD |
| collection | DOAJ |
| description | Objective: Platelets are strongly associated with cardiovascular events due to their role in thrombotic processes. Reticulated platelets have higher prothrombotic potential. The aim of the study was to evaluate the effectiveness of immature platelet fraction (IPF) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS). Methods: This prospective, observational study enrolled patients with ACS treated with dual antiplatelet therapy comprising acetylsalicylic acid and clopidogrel or ticagrelor. The primary outcome was a composite endpoint defined as major adverse cardiovascular events (MACE): all-cause death, myocardial infarction (MI), ischemic stroke, or unplanned revascularization. IPF was determined using flow cytometry in the first 24 h of hospitalization. MACE were evaluated by 2 physicians based on electronic databases and source documentation including discharge letters received from patients upon telephone contact. Results: Overall, there were 140 ACS patients (mean age 65.1 ± 11.7, 37 females [26.4%]) included in this study. Of them, 22.9% had diabetes mellitus, 69.3% hyperlipidemia, 25% had a history of MI. The median IPF values were 2.85 [1.8-4.2] %. Clinical follow-up (median time: 57 months [interquartile range 55-59 months]) was available for 130 patients (92.9%). MACE occurred in 27 patients (20.8%). There were higher rates of MACE at higher IPF tertiles (3rd vs 1st tertile: HR = 5.341 95% CI: 1.546-18.454, P = .008). Cox regression analyses showed that IPF level was independently associated with MACE. Time-dependent receiver-operating characteristic curve analysis revealed area under the curve of 0.656 for 5-year outcome with an IPF cutoff point of 3.45% being 63.0% sensitive and 65.0% specific for MACE. Conclusions: The study showed IPF may be an independent predictor of long-term mortality and MACE (ClinicalTrials.gov number, NCT06177587). |
| first_indexed | 2024-03-08T15:25:43Z |
| format | Article |
| id | doaj.art-9f3791e80e1c407192496f6ba699ad7d |
| institution | Directory Open Access Journal |
| issn | 1940-4034 |
| language | English |
| last_indexed | 2024-03-08T15:25:43Z |
| publishDate | 2024-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Journal of Cardiovascular Pharmacology and Therapeutics |
| spelling | doaj.art-9f3791e80e1c407192496f6ba699ad7d2024-01-10T10:03:21ZengSAGE PublishingJournal of Cardiovascular Pharmacology and Therapeutics1940-40342024-01-012910.1177/10742484231202864Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet TherapyKarolina Gumiężna MD0Piotr Baruś MD1Grażyna Sygitowicz PhD2Agnieszka Wiśniewska PhD3Adrian Bednarek MS4Jakub Zabłocki MS5Adam Piasecki MS6Dominika Klimczak-Tomaniak MD, PhD7Janusz Kochman MD, PhD8Marcin Grabowski MD, PhD9Mariusz Tomaniak MD, PhD10 First Department of Cardiology, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland Department of Clinical Chemistry and Laboratory Diagnostics, , Warsaw, Poland Department of Laboratory Diagnostics, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland Department of Immunology, Transplantation and Internal Medicine, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland First Department of Cardiology, , Warsaw, Poland First Department of Cardiology, , Warsaw, PolandObjective: Platelets are strongly associated with cardiovascular events due to their role in thrombotic processes. Reticulated platelets have higher prothrombotic potential. The aim of the study was to evaluate the effectiveness of immature platelet fraction (IPF) in predicting long-term clinical outcomes in patients with acute coronary syndrome (ACS). Methods: This prospective, observational study enrolled patients with ACS treated with dual antiplatelet therapy comprising acetylsalicylic acid and clopidogrel or ticagrelor. The primary outcome was a composite endpoint defined as major adverse cardiovascular events (MACE): all-cause death, myocardial infarction (MI), ischemic stroke, or unplanned revascularization. IPF was determined using flow cytometry in the first 24 h of hospitalization. MACE were evaluated by 2 physicians based on electronic databases and source documentation including discharge letters received from patients upon telephone contact. Results: Overall, there were 140 ACS patients (mean age 65.1 ± 11.7, 37 females [26.4%]) included in this study. Of them, 22.9% had diabetes mellitus, 69.3% hyperlipidemia, 25% had a history of MI. The median IPF values were 2.85 [1.8-4.2] %. Clinical follow-up (median time: 57 months [interquartile range 55-59 months]) was available for 130 patients (92.9%). MACE occurred in 27 patients (20.8%). There were higher rates of MACE at higher IPF tertiles (3rd vs 1st tertile: HR = 5.341 95% CI: 1.546-18.454, P = .008). Cox regression analyses showed that IPF level was independently associated with MACE. Time-dependent receiver-operating characteristic curve analysis revealed area under the curve of 0.656 for 5-year outcome with an IPF cutoff point of 3.45% being 63.0% sensitive and 65.0% specific for MACE. Conclusions: The study showed IPF may be an independent predictor of long-term mortality and MACE (ClinicalTrials.gov number, NCT06177587).https://doi.org/10.1177/10742484231202864 |
| spellingShingle | Karolina Gumiężna MD Piotr Baruś MD Grażyna Sygitowicz PhD Agnieszka Wiśniewska PhD Adrian Bednarek MS Jakub Zabłocki MS Adam Piasecki MS Dominika Klimczak-Tomaniak MD, PhD Janusz Kochman MD, PhD Marcin Grabowski MD, PhD Mariusz Tomaniak MD, PhD Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy Journal of Cardiovascular Pharmacology and Therapeutics |
| title | Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy |
| title_full | Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy |
| title_fullStr | Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy |
| title_full_unstemmed | Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy |
| title_short | Prognostic Implications of Immature Platelet Fraction at 5-Year Follow-up Among ACS Patients Treated With Dual Antiplatelet Therapy |
| title_sort | prognostic implications of immature platelet fraction at 5 year follow up among acs patients treated with dual antiplatelet therapy |
| url | https://doi.org/10.1177/10742484231202864 |
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