Response to Prasugrel and Levels of Circulating Reticulated Platelets in Patients With ST-Segment Elevation Myocardial Infarction

Perl, Leor; Lerman-Shivek, Hila; Rechavia, Eldad; Vaduganathan, Muthiah; Leshem-Lev, Dorit; Zemer‐Wassercug, Noa; Dadush, Oshrat; Codner, Pablo; Bental, Tamir; Battler, Alexander; Kornowski, Ran; Lev, Eli I.

doi:10.1016/j.jacc.2013.07.110

Cited by 84 publications

(70 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, larger and randomized studies are necessary for proving that these concepts are effective and safe in clinical practice. There are also indications that it is preferentially immature platelets that are recruited into arterial thrombi [106] and if confirmed, this finding may have consequences for treatment with antiplatelet drugs [107].…”

Section: Clinical Utility Of Reticulated/ Immature Plateletsmentioning

confidence: 98%

“…The current literature seems to provide preliminary support for the clinical utility of retPLT or IPF determinations, for risk assessment in acute coronary syndrome [100][101][102][103][104] as well as for monitoring drug treatment of coronary artery disease [78,79,[105][106][107]. However, larger and randomized studies are necessary for proving that these concepts are effective and safe in clinical practice.…”

Section: Clinical Utility Of Reticulated/ Immature Plateletsmentioning

confidence: 99%

See 1 more Smart Citation

Reticulated platelets: analytical aspects and clinical utility

Hoffmann

2014

Clinical Chemistry and Laboratory Medicine (CCLM)

136

147

View full text Add to dashboard Cite

Reticulated platelets are immature platelets circulating in blood; they reflect the activity of megakaryopoiesis in the bone marrow. Therefore, they can be used as a non-invasive test in patients with thrombocytopenia in various clinical conditions. The preferred method of analysis is by flow cytometry. However, there is an evident lack of analytical standardization, making it difficult to compare results obtained in different laboratories. Currently, two types of hematology analyzers are on the market offering fully automated measurement of reticulated or immature platelets: the high end analyzers manufactured by Sysmex (XE-and XN-series) and Abbott (CELL-DYN Sapphire). Although the methods are essentially different and cannot be used interchangeably, both have been proven to have clinical utility. Reticulated or immature platelet assays are useful for the differential diagnosis of thrombocytopenia and for monitoring bone marrow recovery after chemotherapy or stem cell transplantation. These assays may aid clinicians in platelet transfusion decisions when recovery from thrombocytopenia is imminent. In addition, preliminary findings indicate that there is a rationale for reticulated or immature platelets for risk stratification in acute coronary syndromes and for monitoring the effect of treatment with antiplatelet drugs in patients with coronary artery diseases. The aim of this paper is to present the present technology available for measuring reticulated platelets as well as an overview of the current status of clinical application. This overview also indicates that more research is needed before reticulated or immature platelet assays can be applied in other clinical conditions than thrombocytopenia and after transplantation.

show abstract

Section: Clinical Utility Of Reticulated/ Immature Plateletsmentioning

confidence: 98%

Section: Clinical Utility Of Reticulated/ Immature Plateletsmentioning

confidence: 99%

Reticulated platelets: analytical aspects and clinical utility

Hoffmann

2014

Clinical Chemistry and Laboratory Medicine (CCLM)

136

147

View full text Add to dashboard Cite

show abstract

“…В исследовании Перла (Perl) и соавт. [46] были также получены поло-жительные корреляции между содержанием ретикулярных тромбоцитов и остаточной аг-регационной активностью тромбоцитов при применении прасугрела. Однако в более позд-ней работе (выполненной сходным составом ав-торов) таких корреляций выявлено не было [47].…”

Section: ретикулярные тромбоциты у больных с сердечно-сосудистыми патunclassified

Platelet Turnover and Atherothrombosis

Мазуров¹

2017

Aterotromboz

View full text Add to dashboard Cite

ОБОРОТ ТРОМБОЦИТОВ И АТЕРОТРОМБОЗА.В. МАЗУРОВ, д.м.н., профессор, Научный медицинский исследовательский центр кардиологии Минздрава России, Москва КЛЮЧЕВЫЕ СЛОВА: тромбоциты, атеротромбоз, ретикулярные тромбоциты, средний объем тромбоцитов, агрегация тромбоцитов, мегакариоциты, тромбоцитопоэз Тромбоциты играют ведущую роль в инициации атеротромбоза -образования внутрисо-судистых тромбов в участках атеросклеротическом повреждении сосудов. Функциональ-ная (протромботическая) активность тромбоцитов существенным образом варьирует как у здоровых лиц, так и у пациентов с сердечно-сосудистыми заболеваниями. Одной из причин повышения активности тромбоцитов может быть ускорение их продукции и оборота. При стимуляции тромбоцитопоэза в кровотоке появляются крупные и ретику-лярные (с повышенным количеством РНК) «молодые» тромбоциты. Эти тромбоциты со-держат больше адгезивных рецепторов, больше секреторных гранул и обладают повы-шенной способностью к агрегации. В обзоре приводятся данные, указывающие на то, что крупные и ретикулярные тромбоциты являются не только маркерами, но и предик-торами атеротромботических событий, и в первую очередь острого коронарного синдро-ма. Увеличение количества таких тромбоцитов у больных, получающих антитромбоци-тарные препараты, ассоциировано со снижением эффективности их антиагрегантного действия. Предполагается, что появление крупных и ретикулярных тромбоцитов в кро-ви больных с атеросклерозом и атеротромбозом может быть следствием повышения тромбопоэтической активности мегакариоцитов при этих патологических состояниях.KEYWORDS: thrombocytes, atherothrombosis, reticular platelets, average platelet count, platelet aggregation, megakaryocytes, thrombocytopoiesis PLATELET TURNOVER AND ATHEROTHROMBOSIS A.V. MAZUROV, MD, Prof. National Medical Research Cardiology Center, Russian Ministry of Health, MoscowPlatelets play an important role in initiating atherothrombosis, i.e. the formation of blood clots inside a blood vessel at areas of atherosclerotic vascular injury. The functional (prothrombotic) activity of platelets significantly varies both in healthy individuals and in patients with cardiovascular diseases. The increased platelet production and turnover may be one of the reasons for promoting platelet activity. Stimulating thrombocytopoiesis results in large and reticular (with an increased amount of RNA) "young" platelets in the bloodstream. These platelets contain more adhesive receptors, more secretory granules and have an increased aggregation capacity. The review provides data indicating that large and reticular platelets are not only markers, but also predictors of atherothrombotic events, and primarily of acute coronary syndrome. An increase in such platelet count in patients receiving antiplatelet drugs is associated with a decrease in effectiveness of their antiplatelet action. It is assumed that the appearance of large and reticular platelets in the blood of patients with atherosclerosis and atherothrombosis may be a consequence of an increase in the thrombopoietic activity of meg...

show abstract

“…6 For patients with poor-risk disease features, including those with secondary AML (related to therapy or arising from an antecedent myeloid neoplasm) or adverse cytogenetics, the prognosis remains particularly bleak: with conventional chemotherapy, complete remission (CR) is achieved in fewer than 50% of cases (compared to 80% of patients with nonpoor-risk disease), and long-term survival remains at around 10%. 7 Several approaches have been adopted to improve responses to induction therapy that involve maneuvres designed to recruit leukemia cells synchronously into the cell cycle and thus render them potentially more sensitive to cell cycle-specific cytotoxic agents such as cytarabine. One study in younger adults with AML suggested that the cytotoxicity of induction chemotherapy could be enhanced in this way through the concurrent addition of granulocyte colony stimulating factor (G-CSF), although reported improvements in disease-free survival did not translate into an OS benefit.…”

Section: Editorialsmentioning

confidence: 99%

“…This increased thrombotic potential seems to be due to their content of cytosolic mRNA that is translationally active, which enables the expression of ADP receptors and prothrombotic factors. The number of juvenile platelets inversely correlates with responsiveness to clopidogrel 6 and prasugrel, 7 and also predicts adverse cardiovascular prognosis and future ACS. 8 Whether levels of juvenile platelets are a marker of risk or a risk factor 9 for ACS has still not been clarified.…”

mentioning

confidence: 99%

Legacy of blood: does prasugrel inhibit megakaryocytes and do juvenile platelets inherit this inhibition?

Santos‐Gallego

2015

Haematologica

View full text Add to dashboard Cite

A cute coronary syndromes (ACS) are the first cause of death in the Western world. ACS are caused by a ruptured atherosclerotic plaque on the coronary arteries with the formation of a superimposed thrombus which occludes coronary circulation.1 Although novel therapies for atherosclerosis are under study, 2 since the establishment of the role of platelets in ACS pathogenesis, platelet inhibition remains the cornerstone of medical therapy for ACS. The P2Y 12 receptor inhibitor prasugrel has been demonstrated to reduce recurrent ischemic events in ACS patients. Thienopyridines (clopidogrel and prasugrel) are prodrugs requiring biotransformation into an active metabolite. As thienopyridines irreversibly bind and antagonize the P2Y 12 receptor for the entire platelet lifespan, the formation of new platelets is required to recover platelet function. The clinical implications of this pharmacological effect are obvious; the slow offset of the antiplatelet effect due to this irreversible P2Y 12 receptor inhibition may be potentially problematic in the management of patients who are treated before coronary angiography and then require coronary artery bypass graft surgery or who need other unanticipated surgical procedures or who experiment severe bleeding. Given that we do not have a complete understanding of the offset period after discontinuation of thienopyridines, Baaten et al. 4 aimed to investigate the dynamics of platelet functional recovery after prasugrel cessation.Megakaryocytes in the vascular niche of the bone marrow generate platelets by extending long filaments or pseudopods termed proplatelets which protrude through the vascular endothelium into the sinusoid lumen, where platelets, stemming from the proplatelet tips, are released into the bloodstream. Juvenile or immature platelets (also termed reticulated platelets because the presence of mRNA produces a reticulated pattern after staining with thiazole orange very similar to erythroid reticulocytes) represent the youngest component of the circulating platelet pool in animals (less than 24 h old).5 Juvenile platelets exhibit larger volume, a greater number of dense granules, and more aggregation/reactivity than older circulating platelets. This increased thrombotic potential seems to be due to their content of cytosolic mRNA that is translationally active, which enables the expression of ADP receptors and prothrombotic factors. The number of juvenile platelets inversely correlates with responsiveness to clopidogrel 6 and prasugrel, 7 and also predicts adverse cardiovascular prognosis and future ACS. 8 Whether levels of juvenile platelets are a marker of risk or a risk factor 9 for ACS has still not been clarified. In their present manuscript, Baaten et al.4 studied 16 STEMI patients on aspirin and prasugrel, who suspended prasugrel after one year. The authors first confirmed that P2Y 12 -inhibited platelets participate less in thrombosis. Second, the authors showed that ADP-induced platelet aggregation (both using light-transmission aggregometry and th...

show abstract

Response to Prasugrel and Levels of Circulating Reticulated Platelets in Patients With ST-Segment Elevation Myocardial Infarction

Abstract: The proportion of circulating RPs strongly correlates with response to prasugrel in patients with STEMI treated with PCI. High levels of RPs are associated with increased platelet reactivity despite prasugrel treatment.

Cited by 84 publications

References 18 publications

Reticulated platelets: analytical aspects and clinical utility

Reticulated platelets: analytical aspects and clinical utility

Platelet Turnover and Atherothrombosis

Legacy of blood: does prasugrel inhibit megakaryocytes and do juvenile platelets inherit this inhibition?

Contact Info

Product

Resources

About