S.I. FILIPPOVA¹, V.I. RUZOV¹, E.N. ALTYNBAEVA², M.N. GORYACHAYA², O.N. EREMEEVA², A.M. ROMANOVA¹, N.V. CHIGINA¹

¹Ulyanovsk State University, Ulyanovsk

²Ulyanovsk Regional Clinical Hospital for War Veterans, Ulyanovsk

  Contact details:

Filippova S.I. — PhD (Medicine), Associate Professor of the Department of Faculty Therapy

Address: 52 Dzerzhinskogo St., 432071 Ulyanovsk, Russian Federation, tel.: +7-908-479-58-74, e-mail: filippova_si@mail.ru

 The purpose — to investigate gender- and age-related characteristics of the platelet hemostatic component in patients with stable coronary artery disease (CAD) using an integrative assessment of morphometric, functional, and membrane platelet parameters.

Materials and methods. The study included 192 patients aged 65–99 years with stable exertional angina pectoris functional class II–III: 142 (74.0%) women and 50 (26.0%) men. The following platelet morphometric parameters were evaluated: platelet count (PLT), mean platelet volume (MPV), platelet distribution width (PDW-SD), plateletcrit (PCT), and platelet large cell count (P-LCC). Functional platelet characteristics included spontaneous and ADP-induced platelet aggregation at ADP concentrations of 0.1, 1.0, and 5.0 μM (n = 146). Platelet membrane alterations were assessed by atomic force microscopy (AFM) with determination of Young’s modulus (n = 45).

Results. Women demonstrated significantly higher values of PLT (219.00 vs 186.50 × 10⁹/L; p < 0.05), PCT (0.23 vs 0.19%; p < 0.05), and P-LCC (84.55 vs 74.05 × 10⁹/L; p < 0.05). Isolated age-related analysis of morphometric parameters revealed no statistically significant differences. Among aggregation tests, ADP-induced platelet aggregation at 1.0 μM and 5.0 μM appeared to be the most sensitive. No significant differences in Young’s modulus were observed in isolated comparisons by gender or age; however, statistically significant differences were identified after combined stratification by gender and age (p < 0.05).

Conclusion. An integrative assessment of platelet morphometry, functional activity, and nanomechanical properties improves the diagnostic value of platelet studies in geriatric patients with stable coronary artery disease.

Key words: integrative approach, platelet hemostatic system, ADP-induced platelet aggregation, atomic force microscopy, Young’s modulus, geriatric patients

REFERENCES

1. Pustovalova O.V. Features of the vascular-platelet and coagulation links of the hemostasis system in geriatric patients with ischemic heart disease and a history of myocardial infarction. Nauchnyye vedomosti BelGU, 2012, no. 12 (5-6), pp. 62–65 (in Russ.).
2. Skripchenko L.A. Morfofunktsional′nyye osobennosti trombotsitov u bol′nykh ishemicheskoy bolezn′yu serdtsa v sochetanii s sakharnym diabetom 2 tipa: avtoref. dis. …kand. med. nauk [Morphofunctional features of platelets in patients with ischemic heart disease combined with type 2 diabetes mellitus. Synopsis of Dis. PhD med. sciences]. Moscow, 2014.
3. Tzoran I., Hoffman R., Monreal M. Hemostasis and thrombosis in the oldest old. Semin. Thromb. Hemost, 2018, vol. 44 (7), pp. 624–631. DOI: 10.1055/s-0038-1657779
4. Tynngård N., Lindahl T.L., Ramström S. Assays of different aspects of haemostasis — what do they measure? Thrombosis J, 2015, vol. 13, p. 8. DOI: 10.1186/s12959-015-0036-2
5. Balduini C.L. The platelet aggregometer. Haematologica, 2022, vol. 107 (2), p. 352. DOI: 10.3324/haematol.2021.280198
6. Le Blanc J., Mullier F., Vayne C., Lordkipanidzé M. Advances in platelet function testing — light transmission aggregometry and beyond. J. Clin. Med, 2020, vol. 9 (8), p. 2636. DOI: 10.3390/jcm9082636
7. Ding L., Sun L., Wang F. et al. Clinical significance of platelet volume and other platelet parameters in acute myocardial infarction and stable coronary artery disease. Arq. Bras. Cardiol, 2019, vol. 112 (6), pp. 715–719.
8. Hosseini E. et al. Indications of platelet indices in coronary artery disease (CAD): more insights into their diagnostic and prognostic importance. J. Thromb. Thrombolysis, 2025, vol. 58 (7), pp. 806–820.
9. Sansanayudh N., Anothaisintawee T., Muntham D. et al. Mean platelet volume and coronary artery disease: a systematic review and meta-analysis. Int. J. Cardiol, 2014, vol. 175 (3), pp. 433–440. DOI: 10.1016/j.ijcard.2014.06.028
10. Järemo P., Milovanivic M., Richter A. Gender and stable angina pectoris: women have greater thrombin-evoked platelet activity but similar adenosine diphosphate-induced platelet responses. Thromb. Haemost, 2005, vol. 94 (1), pp. 227–228.
11. Angiolillo D.J., Galli M., Alexopoulos D. et al. International consensus statement on platelet function and genetic testing in percutaneous coronary intervention: 2024 update. JACC Cardiovasc. Interv, 2024, vol. 17 (22), pp. 2639–2663. DOI: 10.1016/j.jcin.2024.08.027
12. Boopathi S., Garde A., Paddock S. et al. Platelet mechanotransduction: regulatory cross talk between mechanosensitive receptors and calcium channels. Arterioscler. Thromb. Vasc. Biol, 2023, vol. 43 (7), pp. 1125–1138.
13. Poscablo D.M., Worthington A.K., Smith-Berdan S. et al. An age-progressive platelet differentiation path from hematopoietic stem cells causes exacerbated thrombosis. Cell, 2024, vol. 187 (12), pp. 3090–3107.e21. DOI: 10.1016/j.cell.2024.04.018
14. Ruzov V.I., Altynbayeva E.N., Goryachaya M.N. et al. The effect of hyperbaric oxygenation on the elastic properties of the platelet membrane during their spontaneous aggregation in patients with cardiac comorbidity. Voprosy kurortologii, fizioterapii i lechebnoy fizicheskoy kul′tury, 2018, vol. 95, no. 4, pp. 4–9 (in Russ.).
15. Kishkun A.A. Rukovodstvo po laboratornym metodam diagnostiki [Handbook of laboratory diagnostic methods]. Moscow: GEOTAR-Media, 2007. 800 p.
16. Du Plooy J.N., Buys A., Duim W., Pretorius E. Comparison of platelet ultrastructure and elastic properties in thrombo-embolic ischemic stroke and smoking using atomic force and scanning electron microscopy. PLoS One, 2013, vol. 8 (7), r. e69774. DOI: 10.1371/journal.pone.0069774
17. Sachs L., Denker C., Greinacher A., Palankar R. Quantifying single-platelet biomechanics: An outsider’s guide to biophysical methods and recent advances. Res. Pract. Thromb. Haemost, 2020, vol. 4 (3), pp. 386–401. DOI: 10.1002/rth2.12313