Immature platelet fraction over time and clinical outcomes in patients with acute myocardial infarction

Abstract

Background Immature platelets in the circulation can be measured as immature platelet fraction (IPF). Limited data exist regarding IPF during the course of an acute myocardial infarction (AMI), the association between IPF and extent of cardiac damage, and the long‐term prognostic implications of IPF in patients with AMI. Aims To examine the temporal course of IPF during the first month after AMI, the association between IPF and extent of cardiac damage, and the long‐term prognostic effect of IPF in AMI patients. Methods Patients with AMI treated with percutaneous coronary intervention (PCI) were examined. IPF was evaluated by a Sysmex XN‐3000 autoanalyzer, at 4 time points: baseline; one day post‐PCI; 3 days post‐PCI, and 30 days post‐PCI. The association between peak troponin‐T levels and IPF was evaluated. One‐year clinical outcomes (cardiac hospitalization, urgent revascularization, or death) were assessed. Results One hundred patients were included, mean age was 59.5 ± 11.3 years, 82 were men, 27 had diabetes, and 54 were hospitalized with ST‐segment elevation myocardial infarction (STEMI) and 46 with non‐ST segment elevation myocardial infarction (NSTEMI). The levels of IPF modestly decreased a day after PCI but did not change in subsequent measurements. Peak troponin‐T level was significantly associated with the levels of IPF at all 4 time points. IPF levels three days post‐PCI were associated with the composite clinical outcome at 1 year. Conclusions The levels of IPF following AMI remain relatively stable over a one‐month period. Higher levels of IPF during the acute phase of AMI appear to be associated with worse cardiac outcomes at 1 year.

Stability over time of immature platelet fraction and comparison between EDTA and citrated whole blood samples

“…Based on these results, the opportunity to defer platelet transfusions that would be given when transfusion decisions are based on platelet counts only 21 . IP has also been implicated in several pathologies, such as acute myocardial injury and sepsis, and has been found to be an early predictor of worsening in severe COVID‐19 patients 22–24 . The use of IP measurement, particularly with citrated anticoagulant, could help in patients with pseudothrombocytopenia induced by EDTA anticoagulant.…”

“…21 IP has also been implicated in several pathologies, such as acute myocardial injury and sepsis, and has been found to be an early predictor of worsening in severe COVID-19 patients. [22][23][24] The use of IP measurement, particularly with citrated anticoagulant, could help in patients with pseudothrombocytopenia induced by EDTA anticoagulant. This study has limitations, including the use of only one hematological analyzer and the lack of checking of platelet counts obtained with the reference.…”

Routine and Advanced Laboratory Tests for Hemostasis Disorders in COVID-19 Patients: A Prospective Cohort Study

“…Thus, they are suspected to be implicated in thrombosis during some pathological settings. Indeed, higher troponin levels were associated with higher IP fractions during acute myocardial injury, with a subsequent association with worse cardiac outcomes [ 24 ]. During sepsis, higher A-IPC seems to be associated with the severity and prognosis of patients [ 25 ].…”

Immature platelet fraction in cardiovascular diagnostics and antiplatelet therapy monitoring

“…Moreover, a study performed on 100 patients with STEMI or NSTEMI showed, that IPF levels tend to decline during a day after a successful PCI (p < 0.001) and remain stable over the first month [31]. It also revealed, that high IPF levels correlate with increased troponin levels (p = 0.001), which might be a ground for future studies to exploit another feature of the IPFs, as the troponin level was shown to correlate with infarct size [32,33].…”