The Myocardial Infarction Platelet Transcriptome

Despite the abundance of data demonstrating the critical role of platelets in myocardial infarction (MI), few studies have characterized the MI-platelet transcriptome in the acute or chronic setting. The association between MI subtype and platelet transcriptomic signature have not been explored. We report that transcripts associated with actin cytoskeleton and Rho family GTPase signaling, mitochondrial dysfunction, and inflammatory signaling are enriched in platelets from MI patients in the acute setting (n=40 MI, n=38 controls), and do not significantly change over time. We identified 79 platelet genes chronically altered post-MI that are also associated with future cardiovascular events in independent cardiovascular disease validationcohort (n=135). Compared to patients with MI with non-obstructive coronary arteries (MINOCA), platelets from patients with MI due to obstructive coronary artery disease (MI-CAD) were enriched in neutrophil activation and proinflammatory signaling pathways driven by increased TNFα signaling. Hierarchical clustering identified three MI transcriptomic subgroups with disinctive pathways and MI correlates, including a group with MI-CAD, and a group that was predominantly MINOCA. Our data demonstrate that platelets from MI patients are phenotypically different from MI-naïve patients, in the acute and chronic setting, and reveal a transcriptomic signature with distinct clinical features.