Variables influencing Platelet Function Analyzer-100TM closure times in healthy individuals


Peter Hellstern, MD, Institute of Hemostaseology and Transfusion Medicine, Academic City Hospital, D-67063 Ludwigshafen, Germany.


We investigated the relationship between platelet function analyzer (PFA-100TM) closure times (CT) and bleeding time (BT), platelet aggregation (PA) induced by ADP, arachidonic acid, and collagen, blood cell counts, and von Willebrand factor (VWF) in 120 well-characterised healthy individuals. Pre-analytical and analytical conditions were standardised comprehensively. In a substantial number of cases the differences between duplicate measurements exceeded 15%. The reference range (5th and 95th percentiles) for CT with the collagen/epinephrine (CEPI) and the collagen/ADP (CADP) cartridge was 93–223 s and 64–117 s respectively. Re-examination of 11 individuals with CEPI-CT above the 95th percentile revealed considerable batch-to-batch variation of CEPI-CT. Males had significantly longer CADP than females (P = 0·002). CEPI and CADP-CT measured pm were significantly longer than corresponding values determined am (P = 0·003 and P < 0·0001 respectively). Blood group O was associated with greater CEPI and CADP-CT and lower VWF levels compared with non-O blood groups (P = 0·008, P = 0·0003 and P < 0·0001 respectively). Linear regression analysis revealed association between CEPI-CT, CADP-CT and VWF (P < 0·0001), but no relationship was found between CT and BT or between CT and PA. We conclude that VWF plasma levels modulate PFA-100TM CT to a greater extent than platelet function. Establishment of reliable reference ranges and careful standardisation of pre-analytical and analytical conditions is a prerequisite for obtaining reliable PFA-100TM results. Duplicate measurements are necessary.