Direct evaluation of antiplatelet therapy in coronary artery disease by comprehensive image-based profiling of circulating platelets.

Journal: Nature communications
Published Date: May 15, 2025

Abstract

Coronary artery disease (CAD) is a leading cause of death globally. Antiplatelet therapy remains crucial in preventing and treating CAD-associated thrombotic complications, but it concurrently amplifies the risk of bleeding. Unfortunately, traditional platelet function measurement methods cannot directly evaluate its efficacy and safety. Here we demonstrate comprehensive image-based profiling of circulating platelets to directly observe thrombotic conditions and assess antiplatelet therapy in CAD patients. Deep learning-based analysis of whole blood samples from 207 CAD patients revealed elevated concentrations of circulating platelet aggregates, especially in acute versus chronic coronary syndrome patients. It also indicated a regimen-dependent reduction in these concentrations upon treatment with antiplatelet drugs, thereby verifying the direct efficacy of the therapy. Notably, consistent concentrations of these aggregates were found in both venous and arterial blood, suggesting venous blood as a reliable therapy efficacy indicator, despite CAD's arterial nature. These findings support personalized and improved antiplatelet therapy in CAD management.

Authors

  • Kazutoshi Hirose
    Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
  • Satoshi Kodera
    Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo.
  • Masako Nishikawa
    Clinical Research Support Center, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
  • Masataka Sato
    Department of Cardiovascular Medicine, The University of Tokyo Hospital.
  • Yuqi Zhou
    Sun Yat-sen University, The Third Affiliated Hospital, Guangzhou, 510640, China. zhouyuqi@mail.sysu.edu.cn.
  • Hongqian Zhang
    Department of Chemistry, Graduate School of Science, The University of Tokyo, Tokyo 113-0033, Japan. goda@chem.s.u-tokyo.ac.jp.
  • Shun Minatsuki
    Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.
  • Junichi Ishida
    Department of Cardiovascular Medicine, The University of Tokyo, Tokyo, Japan.
  • Norifumi Takeda
    Department of Cardiovascular Medicine, The University of Tokyo.
  • Huidong Wang
    College of Electrical and Information Engineering, Lanzhou University of Technology, Lanzhou 730050, P. R. China.
  • Chuiming Kong
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Yunjie Deng
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Junyu Chen
    Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD, 21287, USA.
  • Chenqi Zhang
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Jun Akita
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Yuma Ibayashi
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Ruoxi Yang
    School of Mechanical Engineering, Hebei University of Technology, Tianjin, 300401, P. R. China.
  • Hiroshi Kanno
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Nao Nitta
  • Takeaki Sugimura
    Department of Chemistry, The University of Tokyo, Tokyo, Japan.
  • Norihiko Takeda
    Division of Cardiology and Metabolism, Center for Molecular Medicine, Jichi Medical University.
  • Makoto Kurano
    Department of Clinical Laboratory Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Yutaka Yatomi
  • Keisuke Goda

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