Mean Platelet Volume and Major Adverse Cardiac Events following Percutaneous Coronary Intervention.

BACKGROUND Mean platelet volume (MPV) has been introduced as a simple and accurate method for assessing platelet function, which can be used as a prognostic marker for cardiovascular events. We investigated whether pre-procedural MPV could predict major adverse cardiac events (MACE) in candidates for elective percutaneous coronary intervention (PCI). METHODS In this large retrospective cohort, we reviewed the clinical and follow-up data of 4199 candidates (mean age = 59.9 ± 10.3 years; female patients = 1440 [34.3%]) for elective PCI due to unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). The primary endpoint of the study was the incidence of MACE defined as in-hospital mortality, cardiac death, nonfatal MI, target lesion revascularization (TLR) or target vessel revascularization (TVR). Based on the MPV level tertiles, patients were categorized into three groups for further comparison. RESULTS Higher MPV was significantly associated with older age (P<0.001), hypertension (P<0.001), diabetes mellitus (P=0.003), history of previous CABG (P<0.001) and lower levels of serum triglyceride (P<0.001). The frequency of 1-year MACE was 176 (4.1%) with no significant difference between the MPV tertile groups. The highest MPV tertile could significantly predict MACE in the univariable model (hazard ratio = 1.51, 95% confidence interval: 1.05-2.17; P=0.026). In the adjusted model, the highest MPV tertile was a borderline predictor for MACE (hazard ratio = 1.62, 95% CI: 0.98-2.68; P=0.057). CONCLUSION High MPV was associated with cardiovascular risk factors and older age while high MPV was a borderline independent predictor for 1-year MACE in the candidates for elective PCI.

[1]  Stefan Störk,et al.  EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries , 2016, European journal of preventive cardiology.

[2]  Gökay Nar,et al.  Increased Mean Platelet Volume in Familial Hypercholesterolemia , 2016, Angiology.

[3]  M. Salarifar,et al.  A Risk-Scoring Model to Predict One-year Major Adverse Cardiac Events after Percutaneous Coronary Intervention , 2015, The journal of Tehran Heart Center.

[4]  Andrew D. Johnson,et al.  Cardiovascular correlates of platelet count and volume in the Framingham Heart Study. , 2015, Annals of epidemiology.

[5]  J. DiNicolantonio,et al.  Meta-analysis of randomized controlled trials and adjusted observational results of use of clopidogrel, aspirin, and oral anticoagulants in patients undergoing percutaneous coronary intervention. , 2015, The American journal of cardiology.

[6]  Yali Yao,et al.  Mean Platelet Volume on Admission Improves Risk Prediction in Patients With Acute Coronary Syndromes , 2015, Angiology.

[7]  Deepak L. Bhatt,et al.  Short- versus long-term dual antiplatelet therapy after drug-eluting stent implantation: an individual patient data pairwise and network meta-analysis. , 2015, Journal of the American College of Cardiology.

[8]  Y. Mehrabi,et al.  Current Status of the Clinical Epidemiology of Myocardial Infarction in Men and Women: A National Cross-Sectional Study in Iran , 2015, International journal of preventive medicine.

[9]  Yujie Zhou,et al.  High-Dose Statin Pretreatment Decreases Periprocedural Myocardial Infarction and Cardiovascular Events in Patients Undergoing Elective Percutaneous Coronary Intervention: A Meta-Analysis of Twenty-Four Randomized Controlled Trials , 2014, PloS one.

[10]  A. Farcomeni,et al.  Platelet activation is associated with myocardial infarction in patients with pneumonia. , 2014, Journal of the American College of Cardiology.

[11]  M. Salarifar,et al.  The SYNTAX Score Can Predict Major Adverse Cardiac Events Following Percutaneous Coronary Intervention , 2014, Heart views : the official journal of the Gulf Heart Association.

[12]  Qiang Liu,et al.  Mean platelet volume predicts left descending artery occlusion in patients with non-ST-elevation myocardial infarction , 2014, Platelets.

[13]  A. Abdollahi,et al.  Can a High Reloading Dose of Atorvastatin Prior to Percutaneous Coronary Intervention Reduce Periprocedural Myocardial Infarction? , 2014, Current medical research and opinion.

[14]  M. Mehrpooya,et al.  Prognostic value of mean platelet volume in patients undergoing elective percutaneous coronary intervention , 2014, Anatolian journal of cardiology.

[15]  Alan S. Brown,et al.  ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Societ , 2014, Journal of cardiac failure.

[16]  S. Barra,et al.  Mean platelet volume is associated with the presence of left atrial stasis in patients with non-valvular atrial fibrillation , 2013, BMC Cardiovascular Disorders.

[17]  Binita Shah,et al.  Mean platelet volume and long-term mortality in patients undergoing percutaneous coronary intervention. , 2013, The American journal of cardiology.

[18]  G. Levine,et al.  2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. , 2011, Journal of the American College of Cardiology.

[19]  Y. Islamoğlu,et al.  Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction , 2011, Scandinavian journal of clinical and laboratory investigation.

[20]  M. Salarifar,et al.  Success Rate, Procedural Complications and Clinical Outcomes of Coronary Interventions in Octogenarians: a Case-Control Study , 2011, The journal of Tehran Heart Center.

[21]  D. Choi,et al.  Stroke prediction using mean platelet volume in patients with atrial fibrillation , 2011, Platelets.

[22]  M. Le May,et al.  Usefulness of mean platelet volume as a biomarker for long-term outcomes after percutaneous coronary intervention. , 2011, The American journal of cardiology.

[23]  M. Benn,et al.  High platelet volume and increased risk of myocardial infarction: 39 531 participants from the general population , 2011, Journal of thrombosis and haemostasis : JTH.

[24]  S. Sadeghian,et al.  Prevalence of left main coronary artery disease among patients with ischemic heart disease: insights from the Tehran Angiography Registry. , 2009, Minerva cardioangiologica.

[25]  B. Meier,et al.  Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary intervention. , 2005, Journal of the American College of Cardiology.

[26]  Paul J. Harrison,et al.  Platelet function analysis. , 2005, Blood reviews.

[27]  H. Breddin Can platelet aggregometry be standardized? , 2005, Platelets.

[28]  E. Maltezos,et al.  Mean platelet volume in patients with type 2 diabetes mellitus , 2004, Platelets.

[29]  Z. Hekimsoy,et al.  Mean platelet volume in Type 2 diabetic patients. , 2004, Journal of diabetes and its complications.

[30]  G. Lip,et al.  Platelet morphology and plasma indices of platelet activation in essential hypertension: effects of amlodipine-based antihypertensive therapy , 2004, Annals of medicine.

[31]  K. Huber,et al.  Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease , 2002, British journal of haematology.

[32]  G. Lip,et al.  Platelet activation: assessment and quantification. , 2001, European heart journal.

[33]  H. Holmsen Significance of testing platelet functions in vitro , 1994, European journal of clinical investigation.

[34]  J. van der Lelie,et al.  Mean platelet volume in myocardial infarction. , 1983, British medical journal.

[35]  S. K. Hosseini,et al.  Mean Platelet Volume as a Predictor of One-Year Major Adverse Cardiac Events following Elective Percutaneous Coronary Interventions , 2014, The journal of Tehran Heart Center.

[36]  G. Lip,et al.  Assessment of mean platelet volume in coronary artery disease - what does it mean? , 2007, Thrombosis research.

[37]  F. Hunt A RAPID METHOD FOR ASSESSING MEGATHROMBOCYTES: ITS APPLICATION TO THROMBOCYTOTIC AND ACQUIRED THROMBOCYTOPENIC STATES , 1976, Pathology.