Clinical utility of the platelet function analyzer (PFA-100) for the assessment of the platelet status in patients with congestive heart failure (EPCOT trial).

Journal Article (Clinical Trial;Journal Article)

BACKGROUND: Data from small studies have shown the presence of platelet abnormalities in patients with congestive heart failure (CHF). We sought to characterize the diagnostic utility of platelet function analyzer (PFA-100) in the CHF population. METHODS: Blood samples were obtained for measurement of adenosine diphosphate (ADP)/collagen and epinephrine/collagen shear-induced closure time (CT), whole blood aggregation, platelet contractile force, activity of glycoprotein (GP) IIb/IIIa, and P-selectin receptors in 100 consecutive outpatients with CHF. RESULTS: Substantial interindividual variability of platelet characteristics exists in patients with CHF. There were no statistically significant differences when patients were divided by the incidence of vascular events, emergency revascularization needs, survival, or etiology of heart failure. Aspirin use did not affect instrument readings as well. CT correlates well with whole blood aggregometry (r(2)=.587) and less with GP IIb/IIIa activity (r(2)=.326). No correlation has been observed for the CT with the platelet-bound P-selectin (r(2)=.041) and platelet contractile force measures (r(2)=.028). CONCLUSIONS: PFA-100 is indeed capable to serve as a platelet analyzer and may be successfully used as a screening device. However, patients with heart failure enrolled in the EPCOT trial exhibited a marginal, sometimes oppositely directed changes in the platelet function, challenging the diagnostic utility of PFA-100 to serve as a useful tool for the identification of platelet abnormalities, predicting clinical outcomes, or for the monitoring of antiplatelet strategies in this population.

Full Text

Duke Authors

Cited Authors

  • Serebruany, VL; Alford, AB; Meister, AF; Fuzaylov, SY; Gattis, WA; Gurbel, PA; O'Connor, CM

Published Date

  • March 15, 2001

Published In

Volume / Issue

  • 101 / 6

Start / End Page

  • 427 - 433

PubMed ID

  • 11322999

International Standard Serial Number (ISSN)

  • 0049-3848

Digital Object Identifier (DOI)

  • 10.1016/s0049-3848(00)00431-x


  • eng

Conference Location

  • United States