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Updated: Jun 22, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Association of level of kidney function and platelet aggregation in acute myocardial infarction
Fredrik Karlsson1, Angelo Modica, Thomas Mooe
1Department of Internal Medicine, Section of Cardiology, Ostersund Hospital, Ostersund, Sweden. fredrik.karlsson@jll.se
Insights
Kidney function does not alter platelet aggregation after acute myocardial infarction. Platelet aggregation increased in all patients during hospitalization, with other factors like age and diabetes being more significant predictors.
Area of Science:
- Cardiology
- Nephrology
- Hematology
Background:
- Decreased kidney function is a known risk factor for acute coronary syndrome.
- Increased platelet aggregation in acute coronary syndrome is linked to vascular complications.
Purpose of the Study:
- To investigate the association between reduced kidney function and altered platelet function in acute myocardial infarction patients.
Main Methods:
- Prospective cohort study of 413 acute myocardial infarction patients.
- Estimated glomerular filtration rate (eGFR) assessed using serum cystatin C.
- Platelet aggregation measured via laser light scattering for small platelet aggregates (SPAs) on days 1, 2, 3, and 5.
Main Results:
- Platelet aggregation significantly increased in all patients within the first 3 hospital days (P < 0.001).
- Initially, higher aggregation was observed in patients with eGFR < 60 mL/min/1.73 m(2) on days 2 and 3.
- Multivariable analysis revealed no significant association between decreased kidney function and increased platelet aggregation; older age, higher fibrinogen, and diabetes were significant predictors.
Conclusions:
- Platelet aggregation rises in the initial days post-acute myocardial infarction, irrespective of kidney function.
- No significant difference in platelet aggregation was found based on kidney function levels in this cohort.
Background:
Decreased kidney function has been established as an important risk factor in patients presenting with acute coronary syndrome. In acute coronary syndrome, increased platelet aggregation is associated with vascular complications. The aim of this study is to examine whether decreased kidney function is associated with altered platelet function in patients presenting with acute myocardial infarction.
Study Design:
Prospective cohort.
Setting & Participants:
413 patients presenting with acute myocardial infarction admitted to the cardiac intensive care unit at Ostersund Hospital, Ostersund, Sweden.
Predictors:
Glomerular filtration rate less than 60 mL/min/1.73 m(2) estimated from serum cystatin C level, comorbidity, medications, and markers of inflammation and hemostasis.
Outcomes & Measurements:
Platelet aggregation was assessed by measuring the formation of small platelet aggregates (SPAs) by using a laser light scattering method. A greater SPA level indicates greater platelet aggregation. Platelet aggregation analysis was performed on days 1, 2, 3, and 5 in-hospital.
Results:
We observed a significant increase in platelet aggregation during the first 3 days in the hospital regardless of kidney function (P < 0.001). Platelet aggregation was more pronounced in patients with estimated glomerular filtration rate less than 60 mL/min/1.73 m(2) on day 2 (SPA count, 65,000 versus 47,000; P = 0.01) and day 3 (SPA count, 77,000 versus 52,000; P = 0.02). In a multiple linear regression analysis, decreased kidney function was no longer significantly associated with increased platelet aggregation. Older age, greater plasma fibrinogen level, and diabetes mellitus were associated with increased platelet aggregation in the multivariable model.
Limitations:
During the study period, 78 patients presenting with acute myocardial infarction were not eligible for inclusion. Differences in treatment with antiplatelet medication between the 2 groups might have affected our findings.
Conclusions:
Platelet aggregation increases during the first days after acute myocardial infarction regardless of kidney function. There is no difference in platelet aggregation in patients according to level of kidney function.
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