Increased mean platelet volume at admission independently predicted 30-day all-cause mortality (HR 1.408; 95% CI 1.040-1.906; P=0.027) and large intracoronary thrombus burden in STEMI patients.
Cohort (n=649)
Does mean platelet volume predict intracoronary thrombus burden and short-term mortality in patients with STEMI undergoing primary PCI?
Increased mean platelet volume at admission independently predicts large intracoronary thrombus burden and 30-day all-cause mortality in STEMI patients undergoing primary PCI.
Effect estimate: HR 1.408 (95% CI 1.040 to 1.906)
Absolute Event Rate: 9.8% vs 2.5%
p-value: p=0.027
OBJECTIVES: The aim of this study was to evaluate the impact of mean platelet volume (MPV) on the intracoronary thrombus burden and short-term mortality in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Platelets play a crucial role in the pathophysiology of coronary artery disease. MPV has been reported to be an indicator of platelet reactivity. METHODS: A total of 649 consecutive STEMI patients who underwent primary PCI between January 2008 and December 2013 were enrolled and divided into two groups based on the thrombus burden: the large thrombus burden (LTB) group and the small thrombus burden (STB) group. The primary endpoint was all-cause mortality at 30 days. RESULT: The LTB group had significantly higher admission MPV compared with the STB group (10.77 ± 1.22 vs. 9.95 ± 1.03, P < 0.001). The cumulative 30-day all-cause mortality rate was significantly higher in the groups with high MPV and LTB (9.8% vs. 2.5%, P < 0.001, 8.6% vs. 4.1%, P = 0.036, respectively). In a receiver operating characteristics analysis, MPV ≥ 10.2 predicted LTB with 73.5% sensitivity and 68.9% specificity. Multivariate logistic regression analysis demonstrated MPV was an independent predictor of large intracoronary thrombus burden (OR 1.794, 95% CI 1.533 to 2.100, P < 0.001) and 30-day all-cause mortality (HR 1.408, 95% CI 1.040 to 1.906, P = 0.027). CONCLUSIONS: Increased MPV at admission is an independent predictor of large intracoronary thrombus burden and short-term mortality. It may be a useful biomarker for risk stratification in patients with STEMI undergoing primary PCI. © 2015 Wiley Periodicals, Inc.
Lai et al. (Thu,) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI (n=649). High mean platelet volume (MPV) vs. Low mean platelet volume (MPV) was evaluated on all-cause mortality at 30 days (HR 1.408, 95% CI 1.040 to 1.906, p=0.027). Increased mean platelet volume at admission independently predicted 30-day all-cause mortality (HR 1.408; 95% CI 1.040-1.906; P=0.027) and large intracoronary thrombus burden in STEMI patients.