Reticulated platelets predict cardiovascular death in acute coronary syndrome patients

Francesca Cesari; Rossella Marcucci; Anna Maria Gori; Roberto Caporale; Alessandra Fanelli; Giulia Casola; Daniela Balzi; Alessandro Barchielli; Serafina Valente; Cristina Giglioli; Gian Franco Gensini; Rosanna Abbate

doi:10.1160/TH12-09-0709

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2013; 109(05): 846-853
DOI: 10.1160/TH12-09-0709

Theme Issue Article

Schattauer GmbH

Reticulated platelets predict cardiovascular death in acute coronary syndrome patients

Insights from the AMI-Florence 2 Study

Francesca Cesari

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Rossella Marcucci

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Anna Maria Gori

²Don Carlo Gnocchi Foundation Italy, Florence, Italy

,

Roberto Caporale

³Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Alessandra Fanelli

³Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Giulia Casola

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Daniela Balzi

⁴Epidemiology Unit, Local Health Unit 10, Florence, Italy

,

Alessandro Barchielli

⁴Epidemiology Unit, Local Health Unit 10, Florence, Italy

,

Serafina Valente

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Cristina Giglioli

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

,

Gian Franco Gensini

²Don Carlo Gnocchi Foundation Italy, Florence, Italy

,

Rosanna Abbate

¹Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy

› Author Affiliations

Abstract

Summary

Reticulated platelets (RP) are newly-formed platelets with a greater mass, a residual amount of RNA and an increased prothrombotic potential. No studies investigating the association between RP and the risk of cardiovascular death in acute coronary syndrome (ACS) patients are available. In the frame of the AMI-Florence 2 study, we investigated RP in 229 (154 M/ 75 F) ACS patients (125 ST-elevation myocardial infarction [STEMI]; 104 Non-STEMI/Unstable Angina). RP were measured by using the Sysmex XE-2100 haematology analyzer and were expressed as the percentage of RP out of the total optical platelet count (immature platelet fraction; IPF) and as the percentage of RP highly fluorescent (H-IPF). At one-year follow-up, 22 out of 229 patients (9.6%) died from cardiovascular causes. Higher values of IPF (p=0.05) and H-IPF (p=0.006) were detected in dead compared to alive patients. A receiver operating characteristics curve analysis identified IPF ≥3.3% and H-IPF ≥0.9% as optimal cut-off values to predict cardiovascular death. At the multivariate model adjusted for the Global Registry of Acute Coronary Events (GRACE) risk score, the association between RP and cardiovascular death remained significant for both IPF [OR (95%CI) : 4.15 (1.24–13.91) p=0.02] and H-IPF [OR (95%CI): H-IPF 5.03 (1.38–18.38) p=0.01]. In conclusion, RP are independent predictors of cardiovascular death and may be useful in improving risk stratification for ACS patients. Future prospective studies to evaluate the role of RP in determining cardiovascular events are warranted.

Keywords

Acute coronary syndrome - cardiovascular death - platelet turn-over - reticulated platelets

Full Text

References

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