Platelet function predicts myocardial damage in patients with acute myocardial infarction
Abstract
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.
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Greater platelet reactivity is associated with larger end-organ injury and worse prognosis.
“enhanced platelet reactivity is associated with both the extent of end organ injury and adverse prognosis (Frossard et al., 2004; Tantry et al., 2013).”
From Gut Microbial Metabolite TMAO Enhances Platelet Hyperreactivity and Thrombosis Risk (2016) · cites this paper as Frossard et al., 2004
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- Authors
- Frossard, M., Fuchs, I., Leitner, J. M., Hsieh, K., Vlcek, M., Losert, H., Domanovits, H., Schreiber, W., Laggner, A. N., & Jilma, B.
- Affiliations
- University of Vienna (AT)
- Venue
- Circulation
- Published
- 2004-09-14
- Volume
- 110
- Issue
- 11
- Pages
- 1392-1397
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2156637699
- Cited by
- 254
- References
- 36
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 10 · 2023: 6 · 2022: 5 · 2021: 9 · 2020: 10 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 8 · 2015: 7 · 2014: 6 · 2013: 10 · 2012: 19
- FWCI
- 13.10
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Hematology › Platelet Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Keywords
- platelet function, acute myocardial infarction, ST-elevation myocardial infarction, platelet function analyzer, high shear rate, von Willebrand factor, platelet hyperreactivity, myocardial injury, creatine kinase-MB, troponin T, risk stratification, acute coronary syndrome
- MeSH terms
- Clopidogrel, Abciximab, Tirofiban, Eptifibatide, Adenosine Diphosphate, Aged, Antibodies, Monoclonal, Anticoagulants, Aspirin, Cardiovascular Agents, Collagen, Female, Humans, Immunoglobulin Fab Fragments, Leukocyte Count, Male, Middle Aged, Myocardial Infarction, Myocardium, Necrosis, Peptides, Platelet Aggregation Inhibitors, Platelet Function Tests, Predictive Value of Tests, Prospective Studies, Ticlopidine, Tyrosine, von Willebrand Factor, Platelet Activation, Comorbidity, Myocardial Ischemia
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