Hirose Kazutoshi, Kodera Satoshi, Nishikawa Masako, Sato Masataka, Zhou Yuqi, Zhang Hongqian, Minatsuki Shun, Ishida Junichi, Takeda Norifumi, Wang Huidong, Kong Chuiming, Deng Yunjie, Chen Junyu, Zhang Chenqi, Akita Jun, Ibayashi Yuma, Yang Ruoxi, Kanno Hiroshi, Nitta Nao, Sugimura Takeaki, Takeda Norihiko, Kurano Makoto, Yatomi Yutaka, Goda Keisuke
Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
Department of Clinical Laboratory Medicine, The University of Tokyo, Tokyo, Japan.
Nat Commun. 2025 May 15;16(1):4386. doi: 10.1038/s41467-025-59664-8.
Coronary artery disease (CAD) is a leading cause of death globally. Antiplatelet therapy remains crucial in preventing and treating CAD-associated thrombotic complications, but it concurrently amplifies the risk of bleeding. Unfortunately, traditional platelet function measurement methods cannot directly evaluate its efficacy and safety. Here we demonstrate comprehensive image-based profiling of circulating platelets to directly observe thrombotic conditions and assess antiplatelet therapy in CAD patients. Deep learning-based analysis of whole blood samples from 207 CAD patients revealed elevated concentrations of circulating platelet aggregates, especially in acute versus chronic coronary syndrome patients. It also indicated a regimen-dependent reduction in these concentrations upon treatment with antiplatelet drugs, thereby verifying the direct efficacy of the therapy. Notably, consistent concentrations of these aggregates were found in both venous and arterial blood, suggesting venous blood as a reliable therapy efficacy indicator, despite CAD's arterial nature. These findings support personalized and improved antiplatelet therapy in CAD management.
冠状动脉疾病（CAD）是全球主要的死亡原因之一。抗血小板治疗在预防和治疗CAD相关的血栓形成并发症方面仍然至关重要，但同时也增加了出血风险。不幸的是，传统的血小板功能测量方法无法直接评估其疗效和安全性。在此，我们展示了基于图像的循环血小板综合分析，以直接观察血栓形成情况并评估CAD患者的抗血小板治疗。对207例CAD患者的全血样本进行基于深度学习的分析发现，循环血小板聚集体浓度升高，尤其是在急性冠状动脉综合征患者与慢性冠状动脉综合征患者中。这也表明在使用抗血小板药物治疗后，这些浓度会因治疗方案而降低，从而验证了该治疗的直接疗效。值得注意的是，在静脉血和动脉血中均发现这些聚集体的浓度一致，这表明尽管CAD本质上是动脉疾病，但静脉血仍是可靠的治疗疗效指标。这些发现支持在CAD管理中进行个性化和改进的抗血小板治疗。
