A10JACC April 1, 2014

Volume 63, Issue 12

Acute Coronary Syndromes

immature platelet Count (ipC) aS a prediCtor oF adverSe CliniCal outComeS

Moderated Poster ContributionsHall CSunday, March 30, 2014, 4:00 p.m.-4:15 p.m.

Session Title: Platelet Activity in ACSAbstract Category: 1. Acute Coronary Syndromes: ClinicalPresentation Number: 1235M-370B

Authors: Homam Ibrahim, Bashar Hannawi, Robert Schutt, Timothy Delao, Colin Barker, Neal Kleiman, The Methodist DeBakey Heart & Vascular Center, Houston, TX, USA

background: Immature platelets contain mRNA that is translationally active, they can be easily detected using a hematoanalyzer and are known to be less responsive to the effects of antiplatelet drugs. The purpose of this study was to determine the prognostic significance of elevated immature platelet count (IPC) in patients with coronary artery disease (CAD).

methods: The study was a prospective cohort of patients with CAD. On enrollment patients underwent platelet aggregation studies and measurement of the IPC. Patients were then followed for the composite end point of death, myocardial infarction, revascularization, or hospitalization for angina. Events were adjudicated by two independent investigators blinded to IPC.

results: Eighty nine patients were followed for a median of 31 months. Patients were stratified into tertiles according to their IPC. Patients in the upper tertile had higher rates of the primary outcome compared to the mid, and lower tertiles (60% vs. 24% vs. 16%, respectively; p=0.001). After adjusting for age, admission diagnosis, index revascularization (PCI or CABG), and ejection fraction, patients in the upper IPC tertile were more likely to suffer the composite outcome (HR 7.9, 95%CI 2.6-23; p<0.001).

Conclusions: IPC is a novel biomarker for risk stratifying patients with coronary artery disease for adverse clinical events , it is readily available as part of complete blood count. Future studies should focus on utilization of this marker for individualized antiplatelet therapy.