Long-Term Thrombotic Events in Patients with Myocardial Infarction: Proteomic Analysis of Platelets and Plasma Combined with Hemostasis Assessment

Aim    To determine factors associated with an increased risk of thrombotic complications during antiplatelet therapy in patients with acute myocardial infarction (AMI) based on a study of the parameters of hemostasis functional activity, as well as the proteomic composition of blood plasma and platelets.
Material and methods    A single-center prospective clinical study assessed hemostasis parameters and quantified the plasma and platelet proteome before and after dual antiplatelet therapy (DAPT) in 98 AMI patients. Clinical data on thrombotic complications that occurred during the follow-up period were collected for 12 months after the inclusion into the study. A statistical analysis of the collected data was performed, and the proteins were identified whose concentrations were associated with an increased risk of late thrombotic complications.
Results    The comparative analysis of patient groups with and without thrombotic complications revealed statistically significant differences in the concentrations of several proteins. The univariate regression analysis identified proteins associated with an increased risk of thrombotic complications in the long term. Statistically significant factors with a 95% confidence interval different from 0 were the concentrations of platelet proteins, including von Willebrand factor, complement component C8 β-chain, and cation-independent mannose-6 phosphate receptor.
Conclusion    The study identified proteins whose concentrations were associated with an increased risk of thrombotic complications in AMI patients taking DAPT. Before implementing these findings in clinical practice, a randomized prospective study should be performed for validation of the study results.

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