Impact of diabetes mellitus on immature platelet fraction and its association with coronary artery disease

Abstract

Background: Higher prothrombotic status and alterations in platelet function and thrombopoiesis are associated with diabetes mellitus (DM). We assessed the impact of diabetes and glucose control on the immature platelet fraction (IPF) and their relationship with prevalence and extent of coronary artery disease (CAD).Methods: Consecutive patients undergoing coronary angiography were included.Significant CAD was defined as at least one vessel stenosis greater than 50%. IPF levels were measured at admission by routine blood cells count (A Sysmex XE-2100). Results:We included 1781 patients, of whom 660 (37.1%) suffered from diabetes.Diabetes was associated with advanced age and a higher cardiovascular risk profile.No difference in the mean values of IPF were observed between patients with or without DM (3.6 ± 2.5 vs 3.5 ± 2.5, P = 0.39) and neither in the rate of patients with IPF above the median (2.9%) (51.6% vs 50.6%, P = 0.73). In patients with DM, the IPF levels did not relate with glucose control parameters (glycaemia: r = −0.024, P = 0.54, glycosylated haemoglobin: r = 0.11, P = 0.72). The prevalence of CAD was significantly lower in patients with DM and IPF greater than the median (80.5% vs 86.5%, P = 0.04, adjusted odds ratio [OR] [95% confidence interval {CI}] = 0.57[0.36-0.91], P = 0.02), while not left main/three-vessel CAD (36.9% vs 38.2%, P = 0.75, adjusted OR [95%CI] = 0.91[0.64-1.28], P = 0.90). Conclusion:In the present study, neither DM nor glucose control are independent predictors of IPF above the median. In patients with DM, higher IPF levels were associated with a lower prevalence of CAD and with a similar extent of severe CAD and angiographic findings. Therefore, until new data become available, elevated IPF should not be systematically applied on a large scale as cardiovascular risk marker in patients with diabetes. K E Y W O R D Scoronary artery disease, coronary angiography, diabetes mellitus, immature platelet fraction

Reticulated Platelets in Medicine: Current Evidence and Further Perspectives

“…Several subanalyses of this study showed no association of levels of RPs with concomitant antiplatelet therapy, use of statins, age or gender [49,50]. Only in the subgroup of patients with CAD and diabetes mellitus were high levels of RPs associated with a lower prevalence of CAD [51], but with a higher incidence of major adverse cardiovascular events and a lower incidence of bleeding [52]. Several studies comparing healthy subjects, patients with stable CAD and patients with ACS showed significant elevated levels of RPs in patients with ACS, especially in patients with STEMI [39,53,54].…”

Role of Reticulated Platelets in Cardiovascular Disease

“…62 Nevertheless, also negative studies without any association between RPs and diabetes exist. 70,71 Reasons for contrasting results could be because of different measurement techniques to assess RPs and the implementation of heterogeneous patient populations.…”