Platelet expression of FcγRIIa was quantified after myocardial infarction (MI) and
we found that patients with high platelet FcγRIIa expression (>11,000/platelet) had
a fourfold greater risk of subsequent MI, stroke, and death. This analysis of the
original cohort of 197 patients was designed to determine whether platelet expression
of FcγRIIa could be used in combination with clinical risk scores (GRACE [Global Registry
of Acute Coronary Events] and DAPT [Dual Antiplatelet Therapy]) to refine cardiovascular
risk assessment. Platelet expression of FcγRIIa quantified with the use of flow cytometry
was broadly distributed in patients stratified into high and low risk groups based
on clinical risk scores. In patients identified as high risk by the GRACE score, 62%
had high platelet FcγRIIa expression. Similarly, in patients identified as high risk
by DAPT, 55% had high platelet FcγRIIa expression. High platelet FcγRIIa expression
discriminated high and low risk cohorts in patients with high cardiovascular risk
defined by either the GRACE score (high platelet FcγRIIa 18.9% vs low platelet FcγRIIa
0%; odds ratio = 15.7, p = 0.06) or the DAPT score (high platelet FcγRIIa 15.4% vs
low platelet FcγRIIa 3.7%; odds ratio = 5.6, p = 0.03) assessment. Platelet expression
of FcγRIIa merits additional study to determine whether low platelet FcγRIIa expression
can be used to guide early transition to aspirin monotherapy and high platelet FcγRIIa
expression can be used to guide continuation of DAPT.
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Article info
Publication history
Published online: December 07, 2019
Received in revised form:
November 27,
2019
Received:
September 26,
2019
Footnotes
This study was supported by a Grant from Janssen Pharmaceuticals, LLC, RIVAROXDVT4004.
Clinical Trial Registration: NCT02505217
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
