Thrombosis and Hemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
Semin Thromb Hemost. 2022 Jul;48(5):542-551. doi: 10.1055/s-0042-1742742. Epub 2022 Feb 28.
Increased platelet activity is an important predictor for recurrent cardiovascular events in patients with acute coronary syndromes (ACS). Flow cytometry is an advanced method for evaluation of platelet activity. We aimed to summarize the current literature on dynamic changes in platelet activity analyzed by flow cytometry in patients with ACS. Employing the guidelines of Preferred Report Items for Systematic Reviews and Meta-Analyses (PRISMA), we searched PubMed and Embase on October 26, 2021, and identified studies measuring platelet activity with flow cytometry in ACS patients in the acute phase (baseline) and at follow-up in a more stable phase. In the 12 included studies, fibrinogen receptor, α-granule secretion, platelet reactivity index, monocyte-platelet aggregates, neutrophil-platelet aggregates, and reticulated platelets were measured. The fibrinogen receptor and α-granule secretion were either unchanged or lower during follow-up measurements than in the acute phase. Platelet reactivity index showed inconsistent results. Values of monocyte-platelet aggregates and neutrophil-platelet aggregates were lower at follow-up than at baseline (-values <0.05). Reticulated platelets were either unchanged (-value >0.64) or lower at 1 to 2 months follow-up (-value 0.04), and also lower at 5 months to 1-year follow-up (-value >0.005) compared with baseline. Overall, flow cytometric analyses of platelet function in ACS patients showed that platelet activity was lower at follow-up than at baseline. However, in some patients, platelet activity remained unchanged from baseline to follow-up, possibly indicating a sustained high platelet activity that may increase the risk of recurrent cardiovascular events.
血小板活性增加是急性冠状动脉综合征（ACS）患者复发性心血管事件的重要预测指标。流式细胞术是评估血小板活性的一种先进方法。我们旨在总结目前关于 ACS 患者通过流式细胞术分析血小板活性的动态变化的文献。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们于 2021 年 10 月 26 日在 PubMed 和 Embase 上进行了检索，并确定了在急性阶段（基线）和更稳定阶段的随访中使用流式细胞术测量 ACS 患者血小板活性的研究。在纳入的 12 项研究中，测量了纤维蛋白原受体、α-颗粒分泌、血小板反应性指数、单核细胞-血小板聚集物、中性粒细胞-血小板聚集物和网织血小板。与急性阶段相比，纤维蛋白原受体和 α-颗粒分泌在随访期间保持不变或降低。血小板反应性指数的结果不一致。与基线相比，随访时单核细胞-血小板聚集物和中性粒细胞-血小板聚集物的值较低（-值<0.05）。网织血小板在 1 至 2 个月随访时保持不变（-值>0.64）或降低（-值 0.04），与基线相比，5 个月至 1 年随访时也降低（-值>0.005）。总的来说，ACS 患者的血小板功能流式细胞术分析表明，随访时血小板活性低于基线。然而，在一些患者中，血小板活性从基线到随访保持不变，这可能表明持续的高血小板活性可能增加复发性心血管事件的风险。
