Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Eur J Haematol. 2018 Sep;101(3):362-367. doi: 10.1111/ejh.13109. Epub 2018 Jul 27.
An increased rate of platelet production is a possible cause of reduced antithrombotic response to once-daily aspirin. Markers of immature platelets (IPs), such as immature platelet count (IPC), immature platelet fraction (IPF), and mean platelet volume (MPV) might be useful for identifying patients who have an increase in their rate of platelet production. However, their potential as markers of platelet production has not been rigorously evaluated. We aimed to investigate the utility of the IPC, IPF, and MPV as surrogates for increased platelet production using coronary artery bypass grafting (CABG) as a model of enhanced thrombopoiesis.
Daily changes in platelet count, IPC, IPF, and MPV were followed in 45 patients undergoing CABG.
The rise in IP markers preceded that in the platelet count. IPC (16% per day increase from nadir) but not IPF or MPV showed a significant and sustained rise, which paralleled the pattern observed with platelet count (18% per day increase from nadir).
Of the 3 markers, IPC was the most promising as surrogates for platelet production. Future studies should evaluate the utility of the IPC to identify patients with cardiovascular disease with reduced response to aspirin who might benefit from twice-daily aspirin.
血小板生成率增加可能是导致每日一次服用阿司匹林抗栓反应降低的原因之一。不成熟血小板（IPs）标志物，如未成熟血小板计数（IPC）、未成熟血小板分数（IPF）和平均血小板体积（MPV），可能有助于识别血小板生成率增加的患者。然而，它们作为血小板生成标志物的潜力尚未得到严格评估。我们旨在使用冠状动脉旁路移植术（CABG）作为增强血小板生成的模型，研究 IPC、IPF 和 MPV 作为血小板生成增加替代指标的效用。
对 45 例行 CABG 的患者进行每日血小板计数、IPC、IPF 和 MPV 的变化监测。
血小板计数的升高先于 IP 标志物的升高。IPC（从最低点每天增加 16%）而非 IPF 或 MPV 显示出显著且持续的升高，与血小板计数的变化模式一致（从最低点每天增加 18%）。
在这 3 个标志物中，IPC 作为血小板生成的替代标志物最有前途。未来的研究应评估 IPC 用于识别心血管疾病患者中阿司匹林反应降低的效用，这些患者可能受益于每日两次服用阿司匹林。
