Clinical Utility of the PFA-100

Favaloro, Emmanuel J.

doi:10.1055/s-0029-1145254

Cited by 288 publications

(313 citation statements)

References 130 publications

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“…The drawbacks of the PFA -100 system are that many variables can affect the results including haematocrit, platelet count, and plasma von Willebrand factor. It also has limited sensitivity and reliability [77,80].…”

Section: Flow Cytometrymentioning

confidence: 99%

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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It is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low-or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.

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Section: Flow Cytometrymentioning

confidence: 99%

Anti-platelet Therapy Resistance – Concept, Mechanisms and Platelet Function Tests in Intensive Care Facilities

Mărginean

Bănescu

Scridon

et al. 2016

The Journal of Critical Care Medicine

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“…The principle of the test is flow of citrated whole blood through the cartridge containing a membrane coated with inductors (COL/ADP or COL/EPI); the output is closure time (CT) of the cartridge, reflecting velocity of platelet plug formation (8). The RR for PFA-100 System is given in Table 1, measuring range is 0-300 s, and sensitivity and specificity are 96.1 and 88.6%, respectively, and coefficient of accuracy is 0.979.…”

Section: Pfa-100 Testmentioning

confidence: 99%

“…In addition, their primary haemostasis (i.e. platelet adhesion and aggregation) was assessed using the platelet function analyser (PFA-100) (8), and compared in the same design.…”

Section: Introductionmentioning

confidence: 99%

Prothrombotic changes due to an increase in thyroid hormone levels

Horáček

Malý

Svilias

et al. 2015

European Journal of Endocrinology

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Objective: With increasing free thyroxine levels, a gradually rising risk of venous thromboembolism has been described in case-control studies. However, reports on the influence of thyroid hormones on haemostasis, while suggesting a hypercoagulable state in thyrotoxicosis, have often been inconclusive. This study evaluates multiple markers of haemostasis and fibrinolysis in a paired design, making it more sensitive to changes in thyroid hormone levels. Design: We analysed multiple variables in patients who shifted from severe hypothyroidism to mild hyperthyroidism during thyroid cancer treatment. Those with possible residual disease were excluded. Methods: Ninety patients following total thyroidectomy were tested on two occasions: i) before radioiodine remnant ablation and ii) 6 weeks later, on levothyroxine (LT 4 ) suppression treatment, and the results were compared using the Wilcoxon's test for paired data. Results: During LT 4 treatment, significant increases (all P!0.001) in fibrinogen (from median 3.4 to 3.8 g/l), von Willebrand factor (from 85 to 127%), factor VIII (from 111 to 148%) and plasminogen activator inhibitor 1 (from 6.5 to 13.9 mg/l) were observed. In addition, the activation times of platelet adhesion and aggregation stimulated with collagen and epinephrine (EPI)/ADP, i.e. closure times in platelet function analyser (PFA-100), were significantly shortened (P!0.001): for EPI from median 148 to 117 s and for ADP from 95 to 80 s. Changes in other tests were less prominent or insignificant. Conclusions: An increase in thyroid hormone levels shifts the haemostatic balance towards a hypercoagulable, hypofibrinolytic state. This may contribute to the increased cardiovascular morbidity and mortality observed even in mild thyrotoxicosis.

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“…However, there are many preanalytical factors such as platelet function, platelet count, red blood cells and plasma von Willebrand factor are known to affect the PFA-100 results. High prevalance of short PFA-100 CT has been associated with high vWF in aspirin-treated patients [23].…”

Section: Discussionmentioning

confidence: 99%