{"id":"3daf77481b26","type":"article","url":"https://hartvaat.nl/2016/07/19/immatuur-plaatjesaantal-versus-gevestigde-voorspellers-van-plaatjesreactiviteit-/","title":"Immatuur plaatjesaantal versus gevestigde voorspellers van plaatjesreactiviteit bij thienopyridinetherapie","title_en":"Comparison of Immature Platelet Count to Established Predictors of Platelet Reactivity During Thienopyridine Therapy.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["biomarkers-cardiovasculair"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2016.04.056","source_url":"https://doi.org/10.1016/j.jacc.2016.04.056","authors":["Christian Stratz","Timo Bömicke","Iris Younas","Anja Kittel","Michael Amann","Christian M Valina","Thomas Nührenberg","Dietmar Trenk","Franz-Josef Neumann","Willibald Hochholzer"],"significance":4,"published":"2016-07-19","source_date":"2016-07-19","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/"],"congress":"","summary_en":"This study compared the immature platelet count with established predictors of platelet reactivity during thienopyridine loading. The novel biomarker showed predictive value for antiplatelet response, potentially informing personalised antiplatelet therapy.","created":"2026-07-03T10:26:14Z","updated":"2026-07-03T13:25:34Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die het immatuur plaatjesaantal vergeleek met gevestigde voorspellers van plaatjesreactiviteit bij patiënten op thienopyridinetherapie. Onderzoekt een nieuwe biomarker voor therapiemonitoring.","abstract_original":"BACKGROUND: Previous data suggest that reticulated platelets significantly affect antiplatelet response to thienopyridines. It is unknown whether parameters describing reticulated platelets can predict antiplatelet response to thienopyridines. OBJECTIVES: The authors sought to determine the extent to which parameters describing reticulated platelets can predict antiplatelet response to thienopyridine loading compared with established predictors. METHODS: This study randomized 300 patients undergoing elective coronary stenting to loading with clopidogrel 600 mg, prasugrel 30 mg, or prasugrel 60 mg. Adenosine diphosphate (ADP)-induced platelet reactivity was assessed by impedance aggregometry before loading (intrinsic platelet reactivity) and again on day 1 after loading. Multiple parameters of reticulated platelets were assessed by automated whole blood flow cytometry: absolute immature platelet count (IPC), immature platelet fraction, and highly fluorescent immature platelet fraction. RESULTS: Each parameter of reticulated platelets correlated significantly with ADP-induced platelet reactivity (p < 0.01 for all 3 parameters). In a multivariable model including all 3 parameters, only IPC remained a significant predictor of platelet reactivity (p < 0.001). In models adjusting each of the 3 parameters for known predictors of on-treatment platelet reactivity including cytochrome P450 2C19 (CYP2C19) polymorphisms, age, body mass index, diabetes, and intrinsic platelet reactivity, only IPC prevailed as an independent predictor (p = 0.001). In this model, IPC was the strongest predictor of on-treatment platelet reactivity followed by intrinsic platelet reactivity. CONCLUSIONS: IPC is the strongest independent platelet count-derived predictor of antiplatelet response to thienopyridine treatment. Given its easy availability, together with its even stronger association with on-treatment platelet reactivity compared with known predictors, including the CYP2C19*2 polymorphism, IPC may become the preferred predictor of antiplatelet response to thienopyridine treatment. (Impact of Extent of Clopidogrel-Induced Platelet Inhibition During Elective Stent Implantation on Clinical Event Rate-Advanced Loading Strategies [ExcelsiorLOAD]; DRKS00006102)."}