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Updated: Jun 25, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Iron-induced platelet aggregation measurement: a novel method to measure platelet function in stenting for ST segment
J J J Smit1, W van Oeveren, J P Ottervanger
1Isala Klinieken, Zwolle, The Netherlands.
Insights
A new platelet function test using stainless steel shows high reproducibility and correlates well with existing methods. This test effectively measures platelet aggregation inhibition in patients undergoing stenting for ST-elevation myocardial infarction, even with multiple antiplatelet drugs.
Area of Science:
- Cardiovascular Medicine
- Biomaterials Science
- Hematology
Background:
- Iron and stainless steel can activate platelets, potentially contributing to stent thrombosis after intracoronary stenting.
- Current platelet function tests have limitations due to suboptimal agonists and reproducibility issues.
Purpose of the Study:
- To evaluate the feasibility and reproducibility of a novel platelet function test using stainless steel as an agonist.
- To compare this new test with existing platelet function tests.
Main Methods:
- Iron (Fe)-induced platelet aggregation (FIPA) was measured in 111 patients with ST-elevation myocardial infarction (STEMI) post-treatment.
- Blood samples were incubated with low carbon steel, and platelet aggregation inhibition was calculated.
- Duplo measurements were performed to assess reproducibility.
Main Results:
- FIPA measurements demonstrated high reproducibility (R=0.942).
- FIPA correlated well with adenosine diphosphate-induced platelet aggregation (R=0.83) but weakly with bleeding time (R=0.56).
- FIPA could be measured in patients where other tests failed.
Conclusions:
- The novel stainless steel-based platelet function test is reproducible and correlates with validated methods.
- This test is suitable for measuring platelet aggregation inhibition in STEMI patients undergoing stenting, including those on multiple antiplatelet regimens.
Background:
Iron and (stainless) steel are potent platelet aggregation activators, and may be involved in stent thrombosis, a serious complication after intracoronary stenting. Current platelet function tests are suboptimal, because of inappropriate agonists and/or lack of reproducibility. We tested the feasibility and reproducibility of a novel platelet function test using stainless steel as an agonist and compared it with other platelet function tests.
Materials And Methods:
In 111 patients with acute ST segment elevation myocardial infarction (STEMI), duplo measurements of iron (Fe)-induced platelet aggregation (FIPA) were performed after clopidogrel, acetylsalicylic acid and/or tirofiban treatment. Within 1 h, citrated blood samples drawn from the femoral sheath before primary percutaneous coronary intervention were added to 100 mg of low carbon steel and after 5 s mixing with vortex, the samples were incubated for 15 min. The ratio between the non-aggregated platelets in the agonist sample and platelets in a reference sample was calculated as the platelet aggregation inhibition.
Results:
FIPA measurement was highly reproducible (correlation coefficient (R)=0.942, P<0.001 between duplo samples). FIPA correlated well with adenosine diphosphate-induced platelet aggregation (R=0.83, P<0.001) but weakly with platelet function analyser-100 bleeding time (R=0.56, P<0.001). FIPA could be measured in patients in which platelet aggregation could not be measured by platelet function analyser-100 or after adenosine diphosphate.
Conclusion:
This study showed good reproducibility of a novel platelet function test using stainless steel as an agonist and showed correlation with validated platelet function tests. We found that the novel platelet function test is a suitable test for measurement of platelet aggregation inhibition in patients undergoing stenting for STEMI, even when they are taking multiple antiplatelet regimens.
