Related Experiment Video
Updated: Jul 14, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Identification of platelet hyper-reactivity measured with a portable device immediately after percutaneous coronary
Gianetti Jacopo1, Volpi Elisabetta, Sbrana Silverio
1Laboratory of Atherosclerosis and Thrombosis, CNR Institute of Clinical Physiology, G. Pasquinucci Hospital, Massa, Italy.
Insights
Platelet hyper-reactivity, measured by collagen-epinephrine closure time (CEPI-CT), predicts in-stent thrombosis (IST) after PCI. A CEPI-CT below 190 seconds within 24 hours post-procedure indicates a higher risk of death or myocardial infarction.
Area of Science:
- Cardiology
- Thrombosis Research
- Platelet Function Analysis
Background:
- Platelet hyper-reactivity is a risk factor for recurrent myocardial ischemia and in-stent thrombosis (IST) post-percutaneous coronary intervention (PCI).
- Standard anti-thrombotic therapies may not fully mitigate this risk.
- The Platelet Function Analyzer (PFA-100) device measures collagen-epinephrine closure times (CEPI-CT) to assess platelet function.
Purpose of the Study:
- To investigate if CEPI-CT, a measure of platelet hyper-reactivity, can predict IST.
- To determine the predictive value of early post-PCI CEPI-CT for adverse cardiovascular events.
Main Methods:
- CEPI-CT was measured in 256 patients (stable angina and ACS) within 30±8 hours after PCI (T0) and again at 1 month (T1).
- Platelet hyperactivity was defined as CEPI-CT < 190 seconds.
- Patients were followed for a mean of 9 months for cardiovascular death or myocardial infarction (MI).
Main Results:
- Baseline CEPI-CT < 190 s was significantly associated with a higher rate of death or MI (4.6% vs. 0.7%, p=0.039).
- Multivariable analysis confirmed baseline CEPI-CT < 190 s as an independent predictor of death or MI (Hazard ratio 6.981, p=0.008).
- While CEPI-CT prolonged significantly by T1 (p=0.03), measurements at T1 did not predict adverse events.
Conclusions:
- A collagen-epinephrine closure time (CEPI-CT) below 190 seconds, measured within 24 hours after PCI, is a significant predictor of in-stent thrombosis (IST).
- IST is defined as the composite outcome of cardiovascular death or myocardial infarction.
- Early platelet function assessment post-PCI can identify patients at high risk for IST.
Introduction:
Platelet hyper-reactivity, despite a standard anti-thrombotic therapy, is a recognized risk factor for recurrent myocardial ischemia and in-stent thrombosis following PCI. We have investigated whether this detrimental condition, measured by collagen-epinephrine closure times (CEPI-CT) with the Platelet Function Analyzer (PFA-100) device could predict IST defined as the composite of cardiovascular death or myocardial infarction.
Materials And Methods:
CEPI-CT was measured in 256 consecutive patients with stable angina (n=103) or ACS (n=153) 30+/-8 h after PCI (T 0) and 1 month later (T1). All patients were followed up for a mean period of 9 months. Platelet hyperactivity was defined as a CEPI-CT<190 s.
Results:
Baseline CEPI-CT<190 s was associated with a higher rate of death or MI (LogRank chi2=4.23, p=0.039) as compared with CEPI-CT>190 s (4.6% vs. 0.7%). Multivariable analysis after adjustment for other risk factors confirmed that baseline CEPI-CT<190 s was an independent correlate for death or MI (Hazard ratio 6.981, p=0.008). At T1 there was a significant prolongation of CEPI-CT (p=0.03) from 208+/-64 s to 240+/-59 s but T1 did not predict any event.
Conclusions:
A CEPI-CT<190 s measured within the first 24 h following PCI predicts IST defined as the occurrence of death or MI.
