Prognostic value of rising mean platelet volume during hospitalization in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

• Published in: BMC cardiovascular disorders Vol. 18; no. 1; p. 226
• Main Authors: Avci, Eyup, Kiris, Tuncay, Çelik, Aykan, Variş, Eser, Esin, Fatma Kayaalti, Köprülü, Diyar, Kadi, Hasan
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.12.2018; BioMed Central; BMC
• Subjects: Acute coronary syndromes; Aged; Aged, 80 and over; Analysis; Angioplasty; Blood diseases; Blood Platelets; Blood tests; Cardiology; Cerebral infarction; Diabetes; Electrocardiography; Female; Heart attack; Heart attacks; Hospital Mortality; Hospitalization; Humans; Male; Mean Platelet Volume; Middle Aged; Mortality; Myocardial infarction; Patients; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - mortality; Platelets; Predictive Value of Tests; Reclassification; Retrospective Studies; Risk Factors; ST Elevation Myocardial Infarction - blood; ST Elevation Myocardial Infarction - diagnosis; ST Elevation Myocardial Infarction - mortality; ST Elevation Myocardial Infarction - surgery; ST segment elevation myocardial infarction; Statistical analysis; Studies; Thrombosis; Time Factors; Treatment Outcome; Mean platelet volume; ST segment elevation myocardial infarction; Mortality
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-018-0970-6

The prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients. Four hundred eighty consecutive STEMI patients were enrolled in this retrospective study. The patients were grouped as survivors (n = 370) or non-survivors (n = 110). MPV at admission, and at 48-72 h was evaluated. Change in MPV (MPV at 48-72 h minus MPV on admission) was defined as ΔMPV. At follow-up, long-term mortality was 23%. The non-survivors had a high ΔMPV than survivors (0.37 (- 0.1-0.89) vs 0.79 (0.30-1.40) fL, p <  0.001). A high ΔMPV was an independent predictor of all cause mortality ((HR: 1.301 [1.070-1.582], p = 0.008). Morever, for long-term mortality, the AUC of a multivariable model that included age, LVEF, Killip class, and history of stroke/TIA was 0.781 (95% CI:0.731-0.832, p <  0.001). When ΔMPV was added to a multivariable model, the AUC was 0.800 (95% CI: 0.750-0.848, z = 2.256, difference p = 0.0241, Fig. 1). Also, the addition of ΔMPV to a multivariable model was associated with a significant net reclassification improvement estimated at 24.5% (p = 0.027) and an integrated discrimination improvement of 0.014 (p = 0.0198). Rising MPV during hospitalization in STEMI patients treated with pPCI was associated with long-term mortality.