Assessment of Cardiovascular Risk by the Combination of Clinical Risk Scores Plus Platelet Expression of FcγRIIa

Published:December 07, 2019DOI:
      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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        • Boylan B
        • Gao C
        • Rathore V
        • Gill JC
        • Newman DK
        • Newman PJ
        Identification of FcgammaRIIa as the ITAM-bearing receptor mediating alphaIIbbeta3 outside-in integrin signaling in human platelets.
        Blood. 2008; 112: 2780-2786
        • Schneider DJ
        • McMahon SR
        • Chava S
        • Taatjes-Sommer HS
        • Meagher S
        • Ehle GL
        • Brummel-Ziedins KE
        FcγRIIa: a new cardiovascular risk marker.
        J Am Coll Cardiol. 2018; 72: 237-238
        • Alnasser SM
        • Huang W
        • Gore JM
        • Steg PG
        • Eagle KA
        • Anderson Jr, FA
        • Fox KA
        • Gurfinkel E
        • Brieger D
        • Klein W
        • van de Werf F
        • Avezum A
        • Montalescot G
        • Gulba DC
        • Budaj A
        • Lopez-Sendon J
        • Granger CB
        • Kennelly BM
        • Goldberg RJ
        • Fleming E
        • Goodman SG
        • GRACE Investigators
        Late consequences of acute coronary syndromes: Global Registry of Acute Coronary Events (GRACE) follow-up.
        Am J Med. 2015; 128: 766-775
        • Yeh RW
        • Secemsky EA
        • Kereiakes DJ
        • Normand SL
        • Gershlick AH
        • Cohen DJ
        • Spertus JA
        • Steg PG
        • Cutlip DE
        • Rinaldi MJ
        • Camenzind E
        • Wijns W
        • Apruzzese PK
        • Song Y
        • Massaro JM
        • Mauri L
        • DAPT Study Investigators
        Development and validation of a prediction rule for benefit and harm of dual antiplatelet therapy beyond 1 year after percutaneous coronary intervention.
        JAMA. 2016; 315: 1735-1749
        • Ueda P
        • Jernberg T
        • James S
        • Alfredsson J
        • Erlinge D
        • Omerovic E
        • Persson J
        • Ravn-Fischer A
        • Tornvall P
        • Svennblad B
        • Varenhorst C
        External validation of the DAPT score in a nationwide population.
        J Am Coll Cardiol. 2018; 72: 1069-1078
        • Hochholzer W
        • Ruff CT
        • Mesa RA
        • Mattimore JF
        • Cyr JF
        • Lei L
        • Frelinger 3rd, AL
        • Michelson AD
        • Berg DD
        • Angiolillo DJ
        • O'Donoghue ML
        • Sabatine MS
        • Mega JL
        Variability of individual platelet reactivity over time in patients treated with clopidogrel: insights from the ELEVATE-TIMI 56 trial.
        J Am Coll Cardiol. 2014; 64: 361-368
        • McMahon SR
        • Chava S
        • Taatjes-Sommer HS
        • Meagher S
        • Brummel-Ziedins KE
        • Schneider DJ
        Variation in platelet expression of FcγRIIa after myocardial infarction.
        J Thromb Thrombolys. 2019; 48: 88-94