Flow Cytometric Assessment of Changes in Platelet Reactivity after Acute Coronary Syndrome: A Systematic Review

Oliver Buchhave Pedersen; Leonardo Pasalic; Peter H. Nissen; Erik Lerkevang Grove; Steen Dalby Kristensen; Anne-Mette Hvas

doi:10.1055/s-0042-1742742

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2022; 48(05): 542-551
DOI: 10.1055/s-0042-1742742

Review Article

Flow Cytometric Assessment of Changes in Platelet Reactivity after Acute Coronary Syndrome: A Systematic Review

Oliver Buchhave Pedersen

¹Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark

²Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

³Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

,

Leonardo Pasalic

⁴Institute of Clinical Pathology and Medical Research, Departments of Clinical and Laboratory Hematology, Westmead University Hospital, Sydney, Australia

,

Peter H. Nissen

¹Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark

³Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

,

Erik Lerkevang Grove

²Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

³Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

,

Steen Dalby Kristensen

²Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

³Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

,

Anne-Mette Hvas

¹Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark

³Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark

› Author Affiliations

Abstract

Increased platelet activity is an important predictor for recurrent cardiovascular events in patients with acute coronary syndromes (ACS). Flow cytometry is an advanced method for evaluation of platelet activity. We aimed to summarize the current literature on dynamic changes in platelet activity analyzed by flow cytometry in patients with ACS. Employing the guidelines of Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched PubMed and Embase on October 26, 2021, and identified studies measuring platelet activity with flow cytometry in ACS patients in the acute phase (baseline) and at follow-up in a more stable phase. In the 12 included studies, fibrinogen receptor, α-granule secretion, platelet reactivity index, monocyte-platelet aggregates, neutrophil-platelet aggregates, and reticulated platelets were measured. The fibrinogen receptor and α-granule secretion were either unchanged or lower during follow-up measurements than in the acute phase. Platelet reactivity index showed inconsistent results. Values of monocyte-platelet aggregates and neutrophil-platelet aggregates were lower at follow-up than at baseline (p-values <0.05). Reticulated platelets were either unchanged (p-value >0.64) or lower at 1 to 2 months follow-up (p-value 0.04), and also lower at 5 months to 1-year follow-up (p-value >0.005) compared with baseline. Overall, flow cytometric analyses of platelet function in ACS patients showed that platelet activity was lower at follow-up than at baseline. However, in some patients, platelet activity remained unchanged from baseline to follow-up, possibly indicating a sustained high platelet activity that may increase the risk of recurrent cardiovascular events.

Keywords

flow cytometry - platelet function tests - platelet activation - acute coronary syndromes

Full Text

References

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