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PFA-100 system: a new method for assessment of platelet dysfunction

E F Mammen1, P C Comp, R Gosselin

  • 1Wayne State University School of Medicine, Detroit, Michigan, USA.

Seminars in Thrombosis and Hemostasis
|May 14, 1998
PubMed
Summary

The PFA-100 system accurately identifies platelet function defects, performing comparably to platelet aggregometry. This analyzer is a valuable tool for screening hemostasis disorders.

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Area of Science:

  • Hematology
  • Clinical Diagnostics
  • Platelet Physiology

Background:

  • Platelet function analyzers are crucial for assessing primary hemostasis.
  • The PFA-100 system utilizes collagen/epinephrine (CEPI) and collagen/ADP (CADP) cartridges.
  • CEPI cartridges detect qualitative platelet defects, including acetylsalicylic acid (ASA)-induced abnormalities, while CADP cartridges detect thrombocytopathies.

Purpose of the Study:

  • To evaluate the diagnostic performance of the PFA-100 system.
  • To compare the PFA-100 system's accuracy against platelet aggregometry.
  • To assess the PFA-100 system's ability to detect various platelet function defects, including ASA use.

Main Methods:

  • A seven-center trial involving 206 healthy subjects and 176 patients with platelet defects, including 127 ASA users.

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  • Comparison of PFA-100 system results with a comprehensive platelet function test panel and platelet aggregometry.
  • Analysis of clinical sensitivity, specificity, and concordance between the two methods.

    • Main Results:

    • The PFA-100 system demonstrated high clinical sensitivity (94.9%) and specificity (88.8%), comparable to aggregometry (94.3% sensitivity, 88.3% specificity).
    • The system accurately identified ASA-induced defects (71.7% detection rate) and congenital thrombocytopathies.
    • Overall agreement between PFA-100 and aggregometry was 87.5% (Kappa index 0.751), indicating equivalent diagnostic capabilities.

    Conclusions:

    • The PFA-100 system is a highly accurate and reliable instrument for discriminating normal from abnormal platelet function.
    • Its ease of operation makes it a useful screening tool for platelet-related hemostasis defects.
    • The PFA-100 system offers comparable diagnostic performance to traditional platelet aggregometry.