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血小板分数随时间变化与急性心肌梗死患者的临床结局。

Immature platelet fraction over time and clinical outcomes in patients with acute myocardial infarction.

机构信息

Cardiology Division, Assuta Ashdod University Hospital, Ashdod, Israel.

Faculty of Health Sciences, Ben Gurion University of the Negev, Joyce and Irving Goldman Medical School, Beer-Sheva, Israel.

出版信息

Int J Lab Hematol. 2021 Oct;43(5):966-972. doi: 10.1111/ijlh.13499. Epub 2021 Mar 14.

Abstract

BACKGROUND

Immature platelets in the circulation can be measured as immature platelet fraction (IPF). Limited data exist regarding IPF during the course of an acute myocardial infarction (AMI), the association between IPF and extent of cardiac damage, and the long-term prognostic implications of IPF in patients with AMI.

AIMS

To examine the temporal course of IPF during the first month after AMI, the association between IPF and extent of cardiac damage, and the long-term prognostic effect of IPF in AMI patients.

METHODS

Patients with AMI treated with percutaneous coronary intervention (PCI) were examined. IPF was evaluated by a Sysmex XN-3000 autoanalyzer, at 4 time points: baseline; one day post-PCI; 3 days post-PCI, and 30 days post-PCI. The association between peak troponin-T levels and IPF was evaluated. One-year clinical outcomes (cardiac hospitalization, urgent revascularization, or death) were assessed.

RESULTS

One hundred patients were included, mean age was 59.5 ± 11.3 years, 82 were men, 27 had diabetes, and 54 were hospitalized with ST-segment elevation myocardial infarction (STEMI) and 46 with non-ST segment elevation myocardial infarction (NSTEMI). The levels of IPF modestly decreased a day after PCI but did not change in subsequent measurements. Peak troponin-T level was significantly associated with the levels of IPF at all 4 time points. IPF levels three days post-PCI were associated with the composite clinical outcome at 1 year.

CONCLUSIONS

The levels of IPF following AMI remain relatively stable over a one-month period. Higher levels of IPF during the acute phase of AMI appear to be associated with worse cardiac outcomes at 1 year.

摘要

背景

循环中的未成熟血小板可作为未成熟血小板分数(IPF)进行测量。在急性心肌梗死(AMI)病程中,关于 IPF 的数据有限,包括 IPF 与心脏损伤程度的关系,以及 AMI 患者中 IPF 的长期预后意义。

目的

检查 AMI 后第一个月内 IPF 的时间进程,IPF 与心脏损伤程度的关系,以及 AMI 患者中 IPF 的长期预后效应。

方法

对接受经皮冠状动脉介入治疗(PCI)的 AMI 患者进行检查。通过 Sysmex XN-3000 自动分析仪在 4 个时间点评估 IPF:基线;PCI 后 1 天;PCI 后 3 天;PCI 后 30 天。评估峰值肌钙蛋白 T 水平与 IPF 的关系。评估 1 年临床结局(心脏住院、紧急血运重建或死亡)。

结果

共纳入 100 例患者,平均年龄为 59.5±11.3 岁,82 例为男性,27 例患有糖尿病,54 例为 ST 段抬高型心肌梗死(STEMI)住院患者,46 例为非 ST 段抬高型心肌梗死(NSTEMI)患者。PCI 后 1 天 IPF 水平略有下降,但随后的测量中并未改变。峰值肌钙蛋白 T 水平与所有 4 个时间点的 IPF 水平显著相关。PCI 后 3 天的 IPF 水平与 1 年时的复合临床结局相关。

结论

AMI 后 IPF 的水平在一个月内相对稳定。AMI 急性期较高的 IPF 水平似乎与 1 年时的心脏结局较差相关。

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