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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
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Rossella Marcucci
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Anna Maria Gori
2   Don Carlo Gnocchi Foundation Italy, Florence, Italy
,
Roberto Caporale
3   Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Alessandra Fanelli
3   Central Laboratory, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Giulia Casola
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Daniela Balzi
4   Epidemiology Unit, Local Health Unit 10, Florence, Italy
,
Alessandro Barchielli
4   Epidemiology Unit, Local Health Unit 10, Florence, Italy
,
Serafina Valente
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Cristina Giglioli
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
,
Gian Franco Gensini
2   Don Carlo Gnocchi Foundation Italy, Florence, Italy
,
Rosanna Abbate
1   Department of Clinical and Experimental Medicine, Thrombosis Centre, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
› Author Affiliations
Further Information

Publication History

Received: 28 September 2012

Accepted after major revision: 01 March 2013

Publication Date:
22 November 2017 (online)

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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
 

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