Objective To investigate the correlation between platelet reactive index (PRI) quantified by flow cytometry and the classical platelet aggregation rate (PAG), and to evaluate the prognostic value of PRI/PAG in patients who suffered with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
Methods From October 2016 to January 2017, 231 consecutive patients with NSTE-ACS admitted to the department of cardiology of Tianjin Chest Hospital and treated with percutaneous coronary intervention were enrolled. Patients were divided into two groups according to the PRI median, the low PRI group (PRI≤55%, n=116) and the high PRI group (PRI>55%, n=115). PAG levels, incidence of major adverse cardiovascular events (MACE), major clinical and biochemical indicators were compared between the two groups. According to the median of PAG level, patients were also divided into two groups, the low PAG group (PAG ≤71%, n=112) and the high PAG group (PAG>71%, n=119). The PRI level, the incidence of MACE, the major clinical and biochemical indexes were also compared between the two groups. Correlation analysis and receiver operating characteristic (ROC) curve were conducted between PRI and PAG. All patients were followed up for 2 years. Taking all-cause death, in-stent restenosis, acute in-stent thrombosis and recurrent acute myocardial infarction as the composite endpoint events, the predictive ability
of PRI, PAG, troponin I (TnI) and other indicators on MACE were evaluated by Cox regression analysis. Results Grouped
by the median of PRI
,
the PAG level and MACE incidence were significantly higher in the high PRI group than those in the
low PRI group
(
P＜0.
01
). Grouping by the median of PAG, the high PAG group also showed higher PRI than that of the other
group (
P＜0.01
). There was no significant difference in the incidence of MACE between the two groups
. Correlation analysis
indicated that PRI was positively correlated with PAG (correlation coefficient
r=0.318, P＜0.01). The ROC curve analysis
showed that the area under the curve (AUC) was 0.873 (95%
CI: 0.839-0.908, P＜0.01
),
with PAG as the test variable and
PRI as the state variable. Cox regression analysis manifested that higher level of PRI
(
HR
=
1.090, 95%CI: 1.038-1.146, P＜
0.01) and male gender patients
(
HR=0.186, 95%CI: 0.053-0.659, P =0.009) were more likely to have adverse cardiovascular
events.
Conclusion PRI calculated by the phosphorylation ratio of vasodilator stimulated phosphoprotein
(VASP)
according to the flow cytometry has a correlation with PAG. For patients with NSTE-ACS, high PRI can predict adverse
cardiovascular events
, which is more efficient than traditional PAG detection
.
