Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

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

doi:10.1016/j.rpth.2024.102652

Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

Oliver Buchhave Pedersen^*, Peter H Nissen, Leonardo Pasalic, Anne-Mette Hvas, Steen Dalby Kristensen, Erik Lerkevang Grove

^*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets. Objectives: To investigate changes in platelet maturity and reactivity after acute STEMI. Methods: Patients diagnosed with STEMI, admitted for primary percutaneous coronary intervention, and treated according to international guidelines, were included. Blood samples were obtained within 24 hours after admission and at 2- to 3-months follow-up. Platelet maturity and reactivity using multicolor flow cytometry with SYTO-13 to categorize platelet maturity, whole blood platelet aggregation, serum thromboxane B2 levels, and standard immature platelet markers (eg, immature platelet count and fraction, and mean platelet volume) were measured. Results: A total of 44 STEMI patients were included. The reactivity of immature platelets was consistently higher at baseline and at follow-up when compared to the entire platelet population and the mature platelet population (all P values < .05). The expression of CD63 (a dense granule marker) in immature platelets was consistently high compared to the entire platelet population and the mature platelet population and did not change from baseline to follow-up (P values > .24). Additionally, a positive significant correlation was found between standard immature platelet markers and the expression of CD63 on platelets both at baseline and follow-up (rho ranging from 0.32 to 0.62, all P values < .05). Conclusion: Immature platelets represent a highly reactive platelet subpopulation crucial for the overall platelet reactivity, partly due to a high expression of dense granules. Despite treatment with loading and maintenance doses of antiplatelet therapy, the reactivity of immature platelets remained high in STEMI patients.

Original language	English
Article number	102652
Journal	Research and Practice in Thrombosis and Haemostasis
Volume	9
Issue	1
ISSN	2475-0379
DOIs	https://doi.org/10.1016/j.rpth.2024.102652
Publication status	Published - Jan 2025

Keywords

ST elevationmyocardial infarction
SYTO-13
blood platelets
mean platelet volume
platelet activation
platelet function tests

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@article{e61a682c5aac42ecb6c7e0083f984da0,

title = "Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction",

abstract = "Background: Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets. Objectives: To investigate changes in platelet maturity and reactivity after acute STEMI. Methods: Patients diagnosed with STEMI, admitted for primary percutaneous coronary intervention, and treated according to international guidelines, were included. Blood samples were obtained within 24 hours after admission and at 2- to 3-months follow-up. Platelet maturity and reactivity using multicolor flow cytometry with SYTO-13 to categorize platelet maturity, whole blood platelet aggregation, serum thromboxane B2 levels, and standard immature platelet markers (eg, immature platelet count and fraction, and mean platelet volume) were measured. Results: A total of 44 STEMI patients were included. The reactivity of immature platelets was consistently higher at baseline and at follow-up when compared to the entire platelet population and the mature platelet population (all P values < .05). The expression of CD63 (a dense granule marker) in immature platelets was consistently high compared to the entire platelet population and the mature platelet population and did not change from baseline to follow-up (P values > .24). Additionally, a positive significant correlation was found between standard immature platelet markers and the expression of CD63 on platelets both at baseline and follow-up (rho ranging from 0.32 to 0.62, all P values < .05). Conclusion: Immature platelets represent a highly reactive platelet subpopulation crucial for the overall platelet reactivity, partly due to a high expression of dense granules. Despite treatment with loading and maintenance doses of antiplatelet therapy, the reactivity of immature platelets remained high in STEMI patients.",

keywords = "ST elevationmyocardial infarction, SYTO-13, blood platelets, mean platelet volume, platelet activation, platelet function tests",

author = "Pedersen, {Oliver Buchhave} and Nissen, {Peter H} and Leonardo Pasalic and Anne-Mette Hvas and Kristensen, {Steen Dalby} and Grove, {Erik Lerkevang}",

year = "2025",

month = jan,

doi = "10.1016/j.rpth.2024.102652",

language = "English",

volume = "9",

journal = "Research and Practice in Thrombosis and Haemostasis",

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Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction. / Pedersen, Oliver Buchhave; Nissen, Peter H; Pasalic, Leonardo et al.
In: Research and Practice in Thrombosis and Haemostasis, Vol. 9, No. 1, 102652, 01.2025.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

AU - Pedersen, Oliver Buchhave

AU - Nissen, Peter H

AU - Pasalic, Leonardo

AU - Hvas, Anne-Mette

AU - Kristensen, Steen Dalby

AU - Grove, Erik Lerkevang

PY - 2025/1

Y1 - 2025/1

N2 - Background: Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets. Objectives: To investigate changes in platelet maturity and reactivity after acute STEMI. Methods: Patients diagnosed with STEMI, admitted for primary percutaneous coronary intervention, and treated according to international guidelines, were included. Blood samples were obtained within 24 hours after admission and at 2- to 3-months follow-up. Platelet maturity and reactivity using multicolor flow cytometry with SYTO-13 to categorize platelet maturity, whole blood platelet aggregation, serum thromboxane B2 levels, and standard immature platelet markers (eg, immature platelet count and fraction, and mean platelet volume) were measured. Results: A total of 44 STEMI patients were included. The reactivity of immature platelets was consistently higher at baseline and at follow-up when compared to the entire platelet population and the mature platelet population (all P values < .05). The expression of CD63 (a dense granule marker) in immature platelets was consistently high compared to the entire platelet population and the mature platelet population and did not change from baseline to follow-up (P values > .24). Additionally, a positive significant correlation was found between standard immature platelet markers and the expression of CD63 on platelets both at baseline and follow-up (rho ranging from 0.32 to 0.62, all P values < .05). Conclusion: Immature platelets represent a highly reactive platelet subpopulation crucial for the overall platelet reactivity, partly due to a high expression of dense granules. Despite treatment with loading and maintenance doses of antiplatelet therapy, the reactivity of immature platelets remained high in STEMI patients.

AB - Background: Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). This could partly be explained by an increase of highly reactive immature platelets. Objectives: To investigate changes in platelet maturity and reactivity after acute STEMI. Methods: Patients diagnosed with STEMI, admitted for primary percutaneous coronary intervention, and treated according to international guidelines, were included. Blood samples were obtained within 24 hours after admission and at 2- to 3-months follow-up. Platelet maturity and reactivity using multicolor flow cytometry with SYTO-13 to categorize platelet maturity, whole blood platelet aggregation, serum thromboxane B2 levels, and standard immature platelet markers (eg, immature platelet count and fraction, and mean platelet volume) were measured. Results: A total of 44 STEMI patients were included. The reactivity of immature platelets was consistently higher at baseline and at follow-up when compared to the entire platelet population and the mature platelet population (all P values < .05). The expression of CD63 (a dense granule marker) in immature platelets was consistently high compared to the entire platelet population and the mature platelet population and did not change from baseline to follow-up (P values > .24). Additionally, a positive significant correlation was found between standard immature platelet markers and the expression of CD63 on platelets both at baseline and follow-up (rho ranging from 0.32 to 0.62, all P values < .05). Conclusion: Immature platelets represent a highly reactive platelet subpopulation crucial for the overall platelet reactivity, partly due to a high expression of dense granules. Despite treatment with loading and maintenance doses of antiplatelet therapy, the reactivity of immature platelets remained high in STEMI patients.

KW - ST elevationmyocardial infarction

KW - SYTO-13

KW - blood platelets

KW - mean platelet volume

KW - platelet activation

KW - platelet function tests

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U2 - 10.1016/j.rpth.2024.102652

DO - 10.1016/j.rpth.2024.102652

M3 - Journal article

C2 - 39845649

SN - 2475-0379

VL - 9

JO - Research and Practice in Thrombosis and Haemostasis

JF - Research and Practice in Thrombosis and Haemostasis

IS - 1

M1 - 102652

ER -

Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

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