Admission Immature Platelet Fraction Is Associated with Acute Coronary Syndrome Category but Not with Angiographic Disease Extent: A Cross-Sectional Study

Abstract

Immature platelet fraction (IPF), a marker of platelet turnover, may reflect thrombotic activity in acute coronary syndrome (ACS). This study evaluated the association of admission IPF with ACS clinical severity and angiographic coronary artery disease burden. In this cross-sectional study, 117 consecutive adults hospitalized with ACS at a tertiary referral hospital in Indonesia were enrolled. IPF was measured on admission before coronary angiography. Angiographic vessel count was available in 98 patients. Associations between IPF and ACS categories or angiographic findings were evaluated using nonparametric tests and proportional-odds ordinal logistic regression adjusted for prespecified clinical covariates. Median IPF increased progressively across ACS categories, from 5.30% in unstable angina pectoris to 6.20% in non–ST-elevation myocardial infarction and 8.60% in ST-elevation myocardial infarction (P = .002; Jonckheere–Terpstra P < .001). After adjustment, each 1% increase in IPF was independently associated with a higher ACS category (odds ratio, 1.14; 95% confidence interval, 1.05–1.25; P = .004). In contrast, IPF was not associated with the number of diseased coronary vessels (P = .44; adjusted odds ratio, 0.99; 95% confidence interval, 0.91–1.08; P = .82), multivessel disease, high-risk coronary anatomy, or left-main stenosis.Admission IPF was independently associated with the clinical severity of ACS but not with the angiographic extent of coronary artery disease, suggesting that IPF reflects the acute thrombotic presentation rather than the underlying anatomical burden of atherosclerosis.