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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Angioplasty, Balloon, Coronary, Blood Platelet Disorders, Collagen, Epinephrine, Female, Humans, In Vitro Techniques, Male, Myocardial Infarction, Platelet Activation, Platelet Function Tests, Risk Factors, Stents, Thrombosis.
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Does identification of platelet hyper-reactivity measured with a portable device immediately after percutaneous coronary intervention predict in stent thrombosis? Context: 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. 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. 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.
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A CEPI-CT<190 s measured within the first 24 h following PCI predicts IST defined as the occurrence of death or MI. Final Decision: yes