Direct evaluation of antiplatelet therapy in coronary artery disease by comprehensive image-based profiling of circulating platelets

Kazutoshi Hirose, Satoshi Kodera, Masako Nishikawa (), Masataka Sato, Yuqi Zhou, Hongqian Zhang, Shun Minatsuki, Junichi Ishida, Norifumi Takeda, Huidong Wang, Chuiming Kong, Yunjie Deng, Junyu Chen, Chenqi Zhang, Jun Akita, Yuma Ibayashi, Ruoxi Yang, Hiroshi Kanno, Nao Nitta, Takeaki Sugimura, Norihiko Takeda, Makoto Kurano, Yutaka Yatomi and Keisuke Goda ()
Additional contact information
Kazutoshi Hirose: The University of Tokyo
Satoshi Kodera: The University of Tokyo
Masako Nishikawa: The University of Tokyo
Masataka Sato: The University of Tokyo
Yuqi Zhou: The University of Tokyo
Hongqian Zhang: The University of Tokyo
Shun Minatsuki: The University of Tokyo
Junichi Ishida: The University of Tokyo
Norifumi Takeda: The University of Tokyo
Huidong Wang: The University of Tokyo
Chuiming Kong: The University of Tokyo
Yunjie Deng: The University of Tokyo
Junyu Chen: The University of Tokyo
Chenqi Zhang: The University of Tokyo
Jun Akita: The University of Tokyo
Yuma Ibayashi: The University of Tokyo
Ruoxi Yang: The University of Tokyo
Hiroshi Kanno: The University of Tokyo
Nao Nitta: CYBO Inc
Takeaki Sugimura: CYBO Inc
Norihiko Takeda: The University of Tokyo
Makoto Kurano: The University of Tokyo
Yutaka Yatomi: The University of Tokyo
Keisuke Goda: The University of Tokyo

Nature Communications, 2025, vol. 16, issue 1, 1-12

Abstract: Abstract Coronary artery disease (CAD) is a leading cause of death globally. Antiplatelet therapy remains crucial in preventing and treating CAD-associated thrombotic complications, but it concurrently amplifies the risk of bleeding. Unfortunately, traditional platelet function measurement methods cannot directly evaluate its efficacy and safety. Here we demonstrate comprehensive image-based profiling of circulating platelets to directly observe thrombotic conditions and assess antiplatelet therapy in CAD patients. Deep learning-based analysis of whole blood samples from 207 CAD patients revealed elevated concentrations of circulating platelet aggregates, especially in acute versus chronic coronary syndrome patients. It also indicated a regimen-dependent reduction in these concentrations upon treatment with antiplatelet drugs, thereby verifying the direct efficacy of the therapy. Notably, consistent concentrations of these aggregates were found in both venous and arterial blood, suggesting venous blood as a reliable therapy efficacy indicator, despite CAD’s arterial nature. These findings support personalized and improved antiplatelet therapy in CAD management.

Date: 2025
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DOI: 10.1038/s41467-025-59664-8

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