# Immatuur plaatjesaantal versus gevestigde voorspellers van plaatjesreactiviteit bij thienopyridinetherapie

*geplaatst 2016-07-19 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2016.04.056 · https://hartvaat.nl/2016/07/19/immatuur-plaatjesaantal-versus-gevestigde-voorspellers-van-plaatjesreactiviteit-/*

Studie die het immatuur plaatjesaantal vergeleek met gevestigde voorspellers van plaatjesreactiviteit bij patiënten op thienopyridinetherapie. Onderzoekt een nieuwe biomarker voor therapiemonitoring.

## English: Comparison of Immature Platelet Count to Established Predictors of Platelet Reactivity During Thienopyridine Therapy.

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.

## Abstract (original, from the publication)

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).

Auteurs: Christian Stratz, Timo Bömicke, Iris Younas, Anja Kittel, Michael Amann, Christian M Valina, Thomas Nührenberg, Dietmar Trenk, Franz-Josef Neumann, Willibald Hochholzer

---
Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2016.04.056. Bijgewerkt 2026-07-03T13:25:34Z. 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.