Abstract 883 Immature platelets (IP) in patients with reduced ventricular function. First results of the PRISCA study

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Immature platelets (IP) in patients with reduced ventricular function. First results of the PRISCA study
J. Blaudischek¹, A. Kille¹, K. Franke¹, N. Corpataux², A. Vömel¹, P. M. Dinse¹, D. Quack¹, P. Ludwig¹, D. Westermann¹, T. Nührenberg¹, W. Hochholzer³
¹Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg / Bad Krozingen, Bad Krozingen; ²Universitätsklinik für Kardiologie, Inselspital - Universitätsspital Bern, Bern, CH; ³Kardiologie & Internistische Intensivmedizin, Klinikum Würzburg Mitte gGmbH, Würzburg;
Background: Immature platelets (IP) or reticulated platelets are RNA-rich, freshly from the bone marrow released thrombozytes. They are known for having a higher thrombogenicity. There are various studies that showed an association of increased levels of IP with coronary artery diseases and thrombembolic events such as stroke. It was recently shown that platelet distribution width is associated with an adverse prognosis in heart failure, which might be explained by a larger volume of IP than mature platelets. Further potential mechanisms for a relation of ventricular function and levels of IP are: Cytokine release, which is associated with cellular stress and increased thrombopoietin release; activation of the coagulation cascade by reduced hemodynamics. However, the association of IP and left ventricular function has not been investigated in detail so far. Methods: The PRISCA study (Predictive value of immature blood cells for risk stratification in cardiovascular patients) is a retrospective study of all patients (17836 patients) admitted to the University Heart Center Freiburg at the campus Bad Krozingen between July 2020 to December 2021. This is a first proof of concept analysis of 9265 patients with echocardiography done during their hospitalization. IP were measured by an automated flow cytometer (Sysmex XN-1000). The left ventricular function was categorized as normal (>51%), mildly (ejection fraction 41-51%), moderately (30-40%) or severely (<30%) reduced. Results: Levels of the immature platelet fraction (IPF) were significantly higher in patients with severe reduced left ventricular function (4.3%[3.0-6.3]) as compared to patients with normal (3.3%[2.6-5.3]), mild (3.6%2.4-5.3] or moderate (3.7%[2.6-5.9] reduced left ventricular function (p<0.001). This association was also seen for right ventricular function: IPF with severe reduced right ventricular function; 4.7%[3.4-6.4]) versus normal (3.4%[2.3-5.1]), mildly (4.0%[2.7-6.1]) and moderately (4.4%[3.2-6.7]) reduced right ventricular function (p<0.001). Conclusion: Levels of IPF show a significant association with left and right ventricular function. If these effects are due to thrombogenic mechanisms needs to be tested in further investigations.
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