Many patients with coronary artery disease (CAD) have reduced the effect of aspirin, which may partly be explained by immature platelets. We aimed to investigate whether immature platelet markers can predict cardiovascular events in a large cohort of stable CAD patients. A total of 900 stable CAD patients were included and followed for a median of 3 years. We measured markers of immature platelets (platelet count, immature platelet count, immature platelet fraction, mean platelet volume, platelet distribution width, platelet mass, and thrombopoietin) using automated flow cytometry and studied their relation to cardiovascular events. Our primary endpoint was a composite of acute myocardial infarction (MI), ischemic stroke, and cardiovascular death. A composite of MI, ischemic stroke, stent thrombosis and all-cause mortality was analyzed as a secondary endpoint. We found no difference in immature platelet markers between CAD patients with or without cardiovascular events. Regression analysis using hazards rates showed that markers of immature platelets did not have any predictive value for endpoints (p-values >.05). Markers of immature platelets did not predict future cardiovascular events during a 3-year follow-up period in CAD patients. This suggests that immature platelets measured in a stable phase does not have a major role in predicting future cardiovascular events.
Keywords: Coronary artery disease; immature platelets; ischemic heart disease; prediction; reticulated platelets.
What is the context? Many patients with coronary artery disease (CAD) have reduced antiplatelet effect of aspirinThe reduced antiplatelet effect of aspirin is most likely multifactorial and may partly be explained by immature plateletsWhat is new? In a cohort of 900 stable CAD patients, we measured markers of immature platelets and studied their relation to cardiovascular events during a 3-year follow-upOur study demonstrated that markers of immature platelets did not predict cardiovascular events in our cohortWhat is the impact? The findings from the present study suggest that immature platelets, measured in a stable phase, do not have a major role in predicting future cardiovascular events in CAD patients.