Immature platelet fraction as a prognostic marker in patients with pulmonary embolism

Introduction: Immature platelet fraction (IPF), a population of young platelets with distinct histological and functional characteristics, is associated with adverse outcomes in several cardiovascular diseases. However, data on the role of IPF in acute pulmonary embolism (PE) is limited. The objective of this study was to evaluate the prognostic significance of IPF levels in patients with acute PE. Methods: All patients admitted to a tertiary care center’s intensive cardiovascular care unit (ICCU) with confirmed diagnosis of acute PE from July 2019 to July 2024 were included. IPF measurement was carried out using an autoanalyzer (Sysmex XN-2000). The correlation between IPF level and outcome of all-cause mortality was assessed. Results: A total of 166 patients were included. Mean age of 65.0 years (±17.3), of whom 92 (55.4%) were male. The overall one-year mortality rate was 9.0% (15 patients), while the 30-day mortality rate was 4.8% (8 patients). Multivariate logistic regression analysis demonstrated that elevated IPF levels were independently associated with increased 30-day mortality (OR 1.36; 95% CI 1.06–1.80, p =.017) and one-year mortality (OR 1.23; 95% CI 1.02–1.5, p =.03). Conclusions: Elevated IPF levels are independently associated with increased 30-day and one-year mortality in patients with acute PE. These findings highlight the potential of IPF as a prognostic marker for short-term outcomes in this patient population. Plain Language Summary: This study looked at a blood test called immature platelet fraction (IPF), which measures the number of young platelets - tiny cells in the blood that help stop bleeding by forming clots. The researchers wanted to know whether IPF levels could help predict the risk of short-term and long-term death in people diagnosed with acute pulmonary embolism (PE), a serious condition caused by blood clots in the lungs. The researchers included 166 patients who had a confirmed diagnosis of acute PE. They measured IPF levels for each patient and tracked who survived during the first 30 days after diagnosis and at one-year. Patients with higher IPF levels had a greater chance of dying during those periods, even after taking other health conditions intoaccount. In medical research, 30-day mortality is often used to assess how serious an illness is and how urgently patients may need treatment, while one-year mortality reflects the longer-term impact of the disease’s severity. These results suggest that IPF could help identify patients with PE who are at higher risk. With more research, this simple blood test may support better monitoring and faster decision-making in early care.