Abstract Number: PB0460
Meeting: ISTH 2020 Congress
Theme: Diagnostics and OMICs » Biomarkers of Thrombosis and Hemostasis
Background: Improvement of thrombotic risk stratification in coronary artery disease (CAD) patients is a major challenge. The currently used risk scores, designed to predict mortality and/or the incidence of adverse cardiovascular events, include clinical and laboratory parameters. None of them takes into consideration the increased platelet activation status, although it has been consistently reported in CAD.
Aims: To evaluate the capacity of platelet-associated activation markers, assessed by whole blood flow cytometry at hospital admission, to predict mortality in CAD patients.
Methods: Surface expression of P-selectin, activated GPIIbIIIa, Tissue Factor [TF] was evaluated in 624 CAD patients (73% stable, 27% NSTEMI) and associated with 5-years all-cause mortality by COX regression model. Euclidean distance method was used to calculate the best cutoff value of platelet-associated TF expression and adjusted (age, gender, diagnosis, antiplatelet therapy, kidney function) Kaplan-Meier survival analysis was performed. The capacity of TF to improve the mortality prediction on top of TIMI Risk Score for Secondary Prevention (TRS2P) was calculated by integrated discrimination improvement (IDI).
Results: All-cause mortality rate was 9.7%. Multivariate analysis indicated that, among the platelet activation markers analyzed, only TF was an independent predictor of all-cause mortality (HR=2.02; 95% CI 1.03, 3.98). In a ROC curve analysis, a cut-off value of 4% TF-positive platelets was calculated. Patients were classified into 2 groups according to TF-cutoff. Adjusted Kaplan-Meier survival analysis showed that patients with levels of TF-positive platelets >4% had worse prognosis (p< 0.0001) compared to those with < 4% TF-positive platelets. Moreover, when the predictive capacity of platelet-associated TF was analyzed on top of TRS2P, it increased the AUC from 0.719 to 0.732 with IDI(TRS2P+TF vs TRS2P)=0.012 (p=0.018).
Conclusions: Our findings highlight platelet-TF as novel marker useful to implement risk stratification since, among the platelet-associated activation markers, it is an independent predictor of all-cause mortality in CAD patients.
To cite this abstract in AMA style:
Brambilla M, Myasoedova V, Canzano P, Bonomi A, Rossetti L, Poggio P, Tremoli E, Camera M. Platelet-Associated Tissue Factor Predicts 5-Years Mortality in Coronary Artery Disease Patients [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/platelet-associated-tissue-factor-predicts-5-years-mortality-in-coronary-artery-disease-patients/. Accessed March 21, 2024.« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/platelet-associated-tissue-factor-predicts-5-years-mortality-in-coronary-artery-disease-patients/