Expression and Clinical Prognostic Value of Platelet in Acute Coronary Syndrome.

PURPOSE

Little is known about the relationship between the level of platelet NOD-like receptor protein 3 (NLRP3) and the severity of acute coronary syndrome (ACS) or the prognostic value of platelet NLRP3 for percutaneous coronary intervention (PCI).

METHODS

Platelets collected from 25 healthy subjects, 23 patients with stable angina pectoris (SAP), and 72 patients with ACS were analyzed by Western blotting and real-time fluorescence quantitative PCR (qPCR). A total of 152 patients with ACS who had undergone PCI were included in this study to evaluate the prognostic value of platelet .

RESULTS

The levels of platelet in both the healthy and SAP groups were clearly lower than in the ACS group (<0.001). According to the Pearson correlation analysis, the expression of platelet was closely related to the mean platelet volume (MPV), left ventricular ejection fraction (LVEF), the Gensini score, and the Global Registry of Acute Coronary Events (GRACE) score (all <0.001). Multivariate logistic regression analysis identified as an independent risk factor for adverse cardiovascular events (ACEs) after PCI (=0.004). The proportion of patients with high expression (the -high group) remaining free of adverse events for 3 years was remarkably lower than that in patients with low expression (the -low group; =0.024). The -high group had a significantly higher proportion of patients with interleukin-1β-expressing (20.4%±6.1%) platelets than the -low group (10.7%±3.5%, <0.001). Moreover, the -high group exhibited higher platelet activity, as indicated by increased PAC-1 binding and CD62P expression, compared with the -low group (<0.001).

CONCLUSION

These results indicated that platelet was a novel potential prognostic factor for patients with ACS that underwent PCI.