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Platelet function predicts myocardial damage in patients with acute myocardial infarction
- Source :
- Circulation. 110(11)
- Publication Year :
- 2004
-
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.
- Subjects :
- Male
Abciximab
Myocardial Infarction
Myocardial Ischemia
Comorbidity
Coronary artery disease
Leukocyte Count
Myocardial infarction
Prospective Studies
biology
Troponin T
Antibodies, Monoclonal
Middle Aged
Clopidogrel
Adenosine Diphosphate
Tirofiban
Cardiology
Female
Collagen
Cardiology and Cardiovascular Medicine
medicine.drug
medicine.medical_specialty
Ticlopidine
Platelet Function Tests
Eptifibatide
Immunoglobulin Fab Fragments
Necrosis
Predictive Value of Tests
Physiology (medical)
Internal medicine
von Willebrand Factor
medicine
Humans
Platelet activation
Aged
Aspirin
Unstable angina
business.industry
Myocardium
Anticoagulants
Cardiovascular Agents
medicine.disease
Platelet Activation
biology.protein
Tyrosine
Creatine kinase
business
Peptides
Platelet Aggregation Inhibitors
Subjects
Details
- ISSN :
- 15244539
- Volume :
- 110
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Circulation
- Accession number :
- edsair.doi.dedup.....06d8feeee50515275d1ff8fbaa216eb5