Department of Cardiology, Ospedale "Maggiore della Carità", Eastern Piedmont University , Novara, Italy.
Department of Medicine, ASST "Spedali Civili", University of Brescia , Brescia, Italy.
Platelets. 2020 Nov 16;31(8):1060-1068. doi: 10.1080/09537104.2020.1714572. Epub 2020 Jan 23.
Despite the fact that elderly patients represent a prevalent and challenging population in the current practice, few data exist on the impact of platelet parameters on cardiovascular risk in these patients. Therefore, the aim of the present study was to evaluate the impact of age on the immature platelet count (IPC) and their relationship with CAD. We included a total of 2236 consecutive patients undergoing coronary angiography in a single center. Elderly patients (age ≥ 75 years) were 756 (33.7%). IPC was measured at admission. Elderly patients were more often females ( < .001), with lower BMI and prevalence of smokers ( < .001), and a more complex cardiovascular risk profile and coronary disease ( = .02). Platelet count decreased with aging ( = .05), whereas no difference in the mean IPC was found between patients < or ≥75 years. In fact, advanced age did not emerge as an independent predictor of IPC above III tertile (≥8.610^6/ml), (adjusted OR[95%CI] = 0.97[0.78-1.21], = .79). When considering elderly patients according to tertiles values of IPC (<5.1,5.1-8.59; ≥8.610^6/ml), we found no impact of IPC on the prevalence of CAD (81.1% vs 84.5% vs 81.5%, = .92; adjusted OR[95%CI] = 1.08[0.67-1.72], = .75) and its extent (37.7% vs 34.5% vs 40.2%, = .57; adjusted OR[95%CI] = 1.22[0.85-1.73], = .28). However, we observed a higher rate of calcified and type C lesions in elderly patients with higher IPC ( = .03 and < .001, respectively). Therefore, advanced age is not associated with higher immature platelet count and the prevalence and severity of CAD. Moreover, IPC does not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients.
尽管老年患者是当前实践中普遍存在且具有挑战性的人群，但关于血小板参数对这些患者心血管风险的影响的数据很少。因此，本研究旨在评估年龄对未成熟血小板计数（IPC）的影响及其与 CAD 的关系。我们纳入了在单一中心接受冠状动脉造影的 2236 名连续患者。老年患者（年龄≥75 岁）为 756 人（33.7%）。入院时测量 IPC。老年患者中女性更多（<0.001），BMI 更低，吸烟者更多（<0.001），心血管风险状况和冠心病更复杂（=0.02）。血小板计数随年龄增长而下降（=0.05），但 75 岁以上患者的平均 IPC 无差异。实际上，高龄不是 IPC 高于第三四分位数（≥8.6×10^6/ml）的独立预测因子（调整后 OR[95%CI]为 0.97[0.78-1.21]，=0.79）。当根据 IPC 的三分位数值（<5.1、5.1-8.59；≥8.6×10^6/ml）考虑老年患者时，我们发现 IPC 对 CAD 的患病率（81.1%、84.5%、81.5%，=0.92）和严重程度（37.7%、34.5%、40.2%，=0.57）均无影响。调整后 OR[95%CI]分别为 1.08[0.67-1.72]，=0.75；1.22[0.85-1.73]，=0.28）。然而，我们发现 IPC 较高的老年患者中钙化和 C 型病变的发生率更高（=0.03 和<0.001）。因此，高龄与较高的未成熟血小板计数以及 CAD 的患病率和严重程度无关。此外，IPC 并不能解释在老年患者中观察到的更高的冠状动脉疾病患病率和严重程度。
