Patients with myocardial infarction whose CADP-CT values fell in the first quartile had 3-fold higher CK-MB and TnT levels than those in the fourth quartile.
Observational (n=216)
Does platelet function measured by PFA-100 predict the extent of myocardial damage in patients presenting with acute coronary syndromes?
Enhanced platelet function under high shear rates, measured by CADP-CT, is an independent predictor of myocardial damage severity in patients presenting with acute myocardial infarction.
BACKGROUND: Platelet activation is a hallmark of acute coronary syndromes. Numerous lines of evidence suggest a mechanistic link between von Willebrand factor or platelet hyperfunction and myocardial damage in patients with acute coronary syndromes. Thus, we assessed whether platelet function under high shear rates (collagen adenosine diphosphate closure times CADP-CTs) measured with the platelet function analyzer (PFA-100) may be enhanced in patients with myocardial infarction (MI) and whether it may predict the extent of myocardial damage as measured by creatine kinase (CK-MB) or troponin T (TnT) levels. METHODS AND RESULTS: Patients with acute chest pain or symptoms suggestive of acute coronary syndromes (n=216) were prospectively examined at an emergency department. CADP-CT was significantly shorter in patients with MI, particularly in those with an ST-segment-elevation MI (STEMI) compared with the other patient groups (unstable angina, stable coronary artery disease, or controls). Furthermore, CADP-CT and collagen epinephrine-CT at presentation were independent predictors of myocardial damage as measured by CK-MB or TnT. Patients with MI whose CADP-CT values fell in the first quartile had 3-fold higher CK-MB and TnT levels than those in the fourth quartile. CONCLUSIONS: Patients with STEMI have significantly enhanced platelet function when measured under high shear rates. CADP-CT is an independent predictor of the severity of MI, as measured by markers of cardiac necrosis. Measurement of platelet function with the PFA-100 may help in the risk stratification of patients presenting with MI.
Frossard et al. (2004) conducted an observational in Acute coronary syndromes / Acute myocardial infarction (n=216). Platelet function under high shear rates (CADP-CT measured with PFA-100) vs. Other patient groups (unstable angina, stable coronary artery disease, or controls) and CADP-CT quartiles was evaluated on Myocardial damage as measured by CK-MB or TnT levels. Patients with myocardial infarction whose CADP-CT values fell in the first quartile had 3-fold higher CK-MB and TnT levels than those in the fourth quartile.