Abstract 857 Association of immature platelets and patients with peripheral arterial disease.

Immature or reticulated platelets (IP) are RNA-rich young platelets released from the bone marrow with a higher thrombogenicity as compared to other platelets. Increased levels of IP are associated with acute coronary syndrome, cardioembolic events and major ischemic cardiovascular events during long-term follow-up in patients with acute coronary syndrome. The association of IP and extend of peripheral arterial disease (PAD) has not been investigated so far.

This subanalysis of the PRISCA study (Predictive value of immature blood cells for risk stratification in cardiovascular patients) analyzed patients admitted to the University Heart Center Freiburg – Bad Krozingen between 07/2020 and 12/2021. At time of admission, routine laboratory was tested including AIPC (absolut immature platelet count) and IPF (immature platelet fraction) which were determined automatically using the Sysmex XN1000-Cytometer. In total, 9169 patients could be included in this analysis. 1375 (14.9%) were diagnosed with PAD in varying expression.

Patient’s demographics showed a typical cardiovascular risk profile (71.7 years in average, 63.0% male, 84.7% arterial hypertension, 60.2% current or former smoker, 78.5% hypercholesterinemia, 37.6% diabetes mellitus).

There was a significant differences between the clinical severity of PAD using the Fontaine classification and the immature platelet fraction (p=0.007). This was mainly driven by a significant difference between patients with a Fontaine stadium IV (3.1% [2.0-4.4]) versus patients with Fontaine stadium IIa (3.6% [2.4-5.9] und IIb (3.5% [2.4-5.2]). However, AIPC showed no significant differences (p=0,128) with the severity of PAD.

Therefor AIPC is significantly associated with 30-day mortality in patients with PAD, adjusted for age and sex (figure 1) while the IPF did not meet the level of significance (figure 2).

In conclusion, IPA and IPF are associated with symptoms and outcome in patients with PAD. Further analysis is needed to define the clinical value of these markers for clinical risk stratification in patients with PAD.

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Association of immature platelets and patients with peripheral arterial disease.
A. Vömel¹, K. Franke¹, A. Kille¹, N. Corpataux², P. M. Dinse¹, Q. Dominik¹, D. Quack¹, P. Ludwig³, J. Blaudischek⁴, K. Kaier⁴, D. Westermann⁵, T. Nührenberg¹, W. Hochholzer⁶
¹Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg / Bad Krozingen, Bad Krozingen; ²Inselspital - Universitätsspital Bern, Bern, CH; ³Klinik für Kardiologie und Angiologie, Universitäts-Herzzentrum Freiburg / Bad Krozingen, Bad Krozingen; ⁴Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg im Breisgau; ⁵Innere Medizin III, Kardiologie und Angiologie, Universitäts-Herzzentrum Freiburg - Bad Krozingen, Freiburg im Breisgau; ⁶Kardiologie & Internistische Intensivmedizin, Klinikum Würzburg Mitte gGmbH, Würzburg;
Immature or reticulated platelets (IP) are RNA-rich young platelets released from the bone marrow with a higher thrombogenicity as compared to other platelets. Increased levels of IP are associated with acute coronary syndrome, cardioembolic events and major ischemic cardiovascular events during long-term follow-up in patients with acute coronary syndrome. The association of IP and extend of peripheral arterial disease (PAD) has not been investigated so far. This subanalysis of the PRISCA study (Predictive value of immature blood cells for risk stratification in cardiovascular patients) analyzed patients admitted to the University Heart Center Freiburg – Bad Krozingen between 07/2020 and 12/2021. At time of admission, routine laboratory was tested including AIPC (absolut immature platelet count) and IPF (immature platelet fraction) which were determined automatically using the Sysmex XN1000-Cytometer. In total, 9169 patients could be included in this analysis. 1375 (14.9%) were diagnosed with PAD in varying expression. Patient’s demographics showed a typical cardiovascular risk profile (71.7 years in average, 63.0% male, 84.7% arterial hypertension, 60.2% current or former smoker, 78.5% hypercholesterinemia, 37.6% diabetes mellitus). There was a significant differences between the clinical severity of PAD using the Fontaine classification and the immature platelet fraction (p=0.007). This was mainly driven by a significant difference between patients with a Fontaine stadium IV (3.1% [2.0-4.4]) versus patients with Fontaine stadium IIa (3.6% [2.4-5.9] und IIb (3.5% [2.4-5.2]). However, AIPC showed no significant differences (p=0,128) with the severity of PAD. Therefor AIPC is significantly associated with 30-day mortality in patients with PAD, adjusted for age and sex (figure 1) while the IPF did not meet the level of significance (figure 2). In conclusion, IPA and IPF are associated with symptoms and outcome in patients with PAD. Further analysis is needed to define the clinical value of these markers for clinical risk stratification in patients with PAD.
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