Key result
High reticulated platelet content (averaging 3 to 10% of circulating platelets) in cardiovascular patients reduces antiplatelet drug efficacy and increases the risk of atherothrombotic events.
Why the study?
To review the properties of reticulated platelets and how variations in their content influence platelet activity, antiplatelet drug efficacy, and thrombotic event rates in cardiovascular disease.
Increased levels of reticulated platelets in cardiovascular patients are associated with reduced efficacy of antiplatelet therapies and a higher risk of atherothrombotic events.
RP content may inform thrombotic risk and antiplatelet response in CVD; leaves open prospective validation before clinical use.
In this review we described the properties of reticulated platelets (RP) and showed how variations of their content might influence platelet activity, efficacy of antiplatelet drugs and the rate of thrombotic events in patients with cardiovascular diseases. RP represent a minor platelet fraction containing residual RNA from megakaryocytes. Platelets have no nucleus and do not synthesize RNA de novo, and RNA of megakaryocytic origin is destroyed during their circulation. That is why only recently produced “young” platelets contain RNA. In healthy donors RP are identified by staining with the RNA specific fluorescent dyes by flow cytofluorimetry or using standard protocols in modern flow haematological analyzers. RP content in blood reflects the level of thrombocytopoesis in the bone marrow. RP on average amounted from 3 to 10% of all platelets in the circulation depending on the method applied for their determination. RP absolute amount and/or their percentage is changed in haematological diseases associated with the alterations of megakaryocyte productive properties. RT measurements in patients with cardiovascular diseases have shown that their content is increased in acute coronary syndrome patients. RP are larger and functionally more active in comparison with not reticulated forms. They more frequently incorporate into the platelet aggregates and contain more intracellular granules. Increase of RT content in the circulation correlates with the increase of the average size and functional activity in the whole platelet population. High RP content in patients with cardiovascular diseases reduces antiaggregative effects of aspirin and P2Y12 APD receptor antagonists and increases the risk of atherothrombotic events.
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Хаспекова et al. (2021) conducted a review in Cardiovascular diseases. High reticulated platelet (RP) content was evaluated. High reticulated platelet content (averaging 3 to 10% of circulating platelets) in cardiovascular patients reduces antiplatelet drug efficacy and increases the risk of atherothrombotic events.
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