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Circulating reticulated platelets over time in patients with myocardial infarction treated with prasugrel or ticagrelor

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Abstract

Reticulated platelets (RP) are young, hyperactive platelets that are increased during situations of enhanced platelet turnover such as acute myocardial infarction (AMI). The dynamics of RP levels after AMI is not established. We aimed to characterize the levels of circulating RP over time in patients with AMI. Patients with AMI treated with ticagrelor or prasugrel who underwent percutaneous coronary intervention (PCI) were tested for circulating RP using flow cytometry with Thiazole orange staining at 3 time points at 2–4 days, 30–60 days and 1 year post PCI. Platelet reactivity was assessed using the VerifyNow P2Y12 assay at these time points (results in platelet reactivity units—PRU). Thirty-five patients were included in the study (mean age 62.6 ± 9.1 years, 82.9 % males). Median RP levels were similar at the first and second time points (17.5 %, IQR 25–75: 10.8–22.4 % and 14.9 %, IQR 25–75: 9.7–26.8 %, respectively; p = 0.75). However, RP levels after 1 year were significantly lower as compared to the first and second time points (10.5 % (IQR 25–75: 5.3–18.1 %), p = 0.005 and p = 0.01, respectively). Residual platelet reactivity was very low at all 3 time points (median PRU 25, IQR 25–75: 7–53) and did not change significantly between them (p = 0.66). No significant correlation was found between levels of RP and PRU at any given time point. RP levels of patients with AMI treated with prasugrel or ticagrelor decrease over time after the acute event. However, RP levels over time do not correlate well with residual platelet reactivity.

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Abbreviations

AMI:

Acute myocardial infarction

PCI:

Percutaneous coronary intervention

RP:

Reticulated platelets

PRU:

P2Y12 reaction units

ACS:

Acute coronary syndrome

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Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Cardiology Department, Rabin Medical Center, Petah Tikva, Israel

    Alon Eisen, Leor Perl, Eldad Rechavia, Noa Zemer-Wassercug, Shirit Kazum, Pablo Codner, Ran Kornowski & Eli I. Lev

  2. The Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel

    Alon Eisen, Leor Perl, Eldad Rechavia, Noa Zemer-Wassercug, Shirit Kazum, Pablo Codner, Ran Kornowski & Eli I. Lev

  3. Hasharon Hospital, Rabin Medical Center, Petah Tikva, Israel

    Hila Lerman-Shivek

  4. Clinical Pharmacy Department, School of Pharmacy, The Hebrew University of Jerusalem, Jerusalem, Israel

    Hila Lerman-Shivek

  5. The Felsenstein Medical Research Institute, Rabin Medical Center, Petah Tikva, Israel

    Dorit Leshem-Lev & Oshrat Dadush

Authors
  1. Alon Eisen
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  2. Hila Lerman-Shivek
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  3. Leor Perl
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  4. Eldad Rechavia
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  5. Dorit Leshem-Lev
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  6. Noa Zemer-Wassercug
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  7. Oshrat Dadush
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  8. Shirit Kazum
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  9. Pablo Codner
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  10. Ran Kornowski
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  11. Eli I. Lev
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Corresponding author

Correspondence to Eli I. Lev.

Additional information

Alon Eisen and Hila Lerman-Shivek contributed equally to the study and are co-first authors of this paper.

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Eisen, A., Lerman-Shivek, H., Perl, L. et al. Circulating reticulated platelets over time in patients with myocardial infarction treated with prasugrel or ticagrelor. J Thromb Thrombolysis 40, 70–75 (2015). https://doi.org/10.1007/s11239-014-1156-4

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  • DOI: https://doi.org/10.1007/s11239-014-1156-4

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