Full Text
Abstract
Introduction. Several studies have demonstrated the association of young platelets amount with the risk of rethrombotic events in patients with acute coronary syndrome, but the relationship between intensity of thrombocytogenesis and the dynamics of platelet functional activity under double antiplatelet therapy (DAT) in acute irreversible ischemia and myocardium necrobiosis remains poorly understood.
Aim: to assess the characteristics of thrombocytopoiesis in comparison with the parameters of functional platelets activity in patients with myocardial infarction with ST segment elevation (STеMI) and treated with DAT.
Materials and methods. Thrombopoietin, stromal cell-derived factor 1, thrombopoietin receptor and D-dimer levels were determined by the enzyme immunoassay method in 101 male patients with STеMI on admission, on the 2nd and 7th days of hospitalization. Platelet aggregation activity, dense granule secretion, platelet count, average platelet volume and relative width of platelet size distribution were assessed on admission and on 7th day.
Results. Within 7 days under DAT in 69.3% of STеMI patients platelet count increased — 270 [227; 279] × 109/L vs. 300 [265, 304] × 109/L (p = 0.007) that was accompanied by reduction of collagen-induced platelet aggregation — 9.0 [7.0; 16.0] Om vs. 6.5 [3.5; 8.5] Om (p = 0.047). The direction and magnitude of platelet count change correlated with thrombopoietin level on admission (R = 0.656; p = 0.039). Together with platelet count rising in STеMI patients D-dimer level increased — 302 [96; 812] ng/ml vs. 126 [94; 325] ng/ml (p = 0.048). We identified boundary conditions of the relative thrombocytopoiesis stability in STеMI patients under DAT: thrombopoietin level — 180–310 pg/ml.
Conclusion. Received data suggest a modification of thrombocytogenesis regulation in STеMI patients treated with DAT; however, the clinical significance of this observation requires further investigation.
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