Incremental predictive value of mean platelet volume/platelet count ratio in in-hospital stroke after acute myocardial infarction

• Published in: Platelets (Edinburgh) Vol. 28; no. 1; pp. 54 - 59
• Main Authors: Guenancia, Charles, Hachet, Olivier, Stamboul, Karim, Béjot, Yannick, Leclercq, Thibault, Garnier, Fabien, Yameogo, Nobila Valentin, de Maistre, Emmanuel, Cottin, Yves, Lorgis, Luc
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.01.2017; Taylor & Francis Group
• Subjects: Acute myocardial infarction; Aged; Aged, 80 and over; Biomarkers; Blood Platelets; C-reactive protein; Cellular Biology; Comorbidity; Female; Hematology; Hospitalization; Human health and pathology; Humans; Life Sciences; Male; Mean Platelet Volume; Middle Aged; Myocardial Infarction; Myocardial Infarction - blood; Myocardial Infarction - complications; Myocardial Infarction - therapy; Odds Ratio; Platelet Count; platelets; Prognosis; Proportional Hazards Models; risk factor; Risk Factors; Stroke; Stroke - epidemiology; Stroke - etiology; Stroke - mortality; Time Factors; C-reactive protein; Acute myocardial infarction; risk factor; stroke; platelets
• ISSN: 0953-7104; 1369-1635
• DOI: 10.1080/09537104.2016.1203397

Stroke is a serious complication after acute myocardial infarction (AMI) and is associated with an increased risk of death. Though the pathophysiological mechanisms are not exactly known, increased inflammation and platelet reactivity could play an important role in the occurrence of stroke during AMI. We aimed to investigate the relationship between both mean platelet volume (MPV), a parameter of platelet function, and C-reactive protein (CRP) and the occurrence of in-hospital ischemic stroke (IHS) after AMI. Data were obtained from a French regional survey for AMI that included 5976 patients admitted to an intensive care unit (ICU) between 2001 and 2010. Patients were divided into two groups according to the occurrence of IHS. MPV, platelet count (PC), and CRP were routinely measured at admission to the ICU; 99 (1.6%) IHSs were recorded during hospitalization after admission for AMI. In multivariate analysis, IHS was independently associated with a history of stroke (OR: 1.99%, CI: 1.1-3.49, p = 0.01), impaired left ventricular ejection fraction <40% (OR: 1.88, 95% CI: 1.20-2.94, p = 0.006), impaired renal function (OR: 1.94, 95% CI: 1.27-2.95, p = 0.002), CRP > 10 mg/l (OR: 2.19, 95% CI: 1.44-3.33, p < 0.001), and MPV/PC ratio (OR: 1.04, 95% CI: 1.01-1.08, p = 0.023). Compared with the first to fourth quintiles, the last quintile of the MPV/PC ratio was associated with higher rates of IHS on survival curve analysis (p = 0.014). At hospital admission, a high MPV/PC ratio and a high level of CRP might help to identify patients at increased risk of IHS. Moreover, these results provide new insights into the potential role played by increased inflammation and platelet reactivity in the occurrence of stroke after AMI.