Ikke Nanda Amalia and Yetti Hernaningsih and Puspa Wardhani, - Role of platelet count, platelet indices, and immature platelet fraction as potential markers for monitoring platelet reactivity in patients with acute coronary syndrome undergoing percutaneous coronary intervention. Bali Medical Journal (Bali MedJ), 13 (2). pp. 582-586. ISSN 2089-1180

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Abstract

The acute coronary syndrome is an acute manifestation of coronary heart disease, which is caused by a ruptured plaque of the coronary artery, thus forming a thrombus formation and resulting in myocardial infarction. Reperfusion therapy in patients with acute coronary syndrome is needed with the aim of preventing the area myocardium from experiencing necrosis by percutaneous coronary intervention using a stent, but this action may be caused by stent re-stenosis, bleeding, or thrombosis. Treatment with dual antiplatelet therapy in patients with acute coronary syndrome after percutaneous coronary intervention is recommended for used to prevent stent restenosis events or bleeding. A combination of aspirin and P2Y12 inhibitors is commonly used, such as thienopyridine-like clopidogrel and prasugrel as well as non-thienopyridine class drugs to reduce the thrombosis formation. Monitoring DAPT after PCI requires monitoring the reactivity platelet by platelet aggregation test, but this examination is rarely carried out because it needs special tools and a fairly expensive inductor. Another marker that is less noticeable is the platelet marker by complete blood count (CBC), which uses a hematology analyzer such as platelet count, which decreases and indicates bleeding. Index platelets (PDW, P-LCR, MPV, and PCT) reflect that platelet reactivity indicators and immature platelet fraction shows the proportion of thrombopoiesis. This review provides a summary of ACS (Definition, classification, and pathophysiology), PCI (Definition, clinical indication, characteristics of stent and complication of PCI), Combination of dual antiplatelet therapy and Platelet measure for monitoring ACS after PCI (Platelet count, index platelets like PDW, P-LCR, MPV, PCT and immature platelet fraction).

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