Key result
High mean platelet volume in acute MI linked to ~131% greater risk of major events.
Why the study?
Does elevated mean platelet volume predict adverse cardiovascular outcomes in patients with acute myocardial infarction?
Cohort (n=1,206)
No
Does elevated mean platelet volume predict adverse cardiovascular outcomes in patients with acute myocardial infarction?
Effect estimate: adjusted OR 2.31 (95% CI 1.60 to 3.35)
p-value: p=<0.001
Elevated mean platelet volume at admission is an independent predictor of adverse cardiovascular outcomes, including mortality and reinfarction, at 1 year in patients with acute myocardial infarction.
Elevated admission MPV was associated with higher post-MI risk; hypothesis-generating and should not yet change practice.
OBJECTIVE: High levels of mean platelet volume (MPV) may be associated with adverse outcomes in patients with myocardial infarction (MI). We examined the association between MPV and the risk of death and adverse cardiovascular outcomes in patients with MI. METHODS: We studied consecutive patients with MI admitted to a tertiary-care hospital during a period of 1 year. MPV was measured at admission and at third month. Patients were followed up for 1-year primary composite outcome of cardiovascular death, stroke, fatal or non-fatal MI and cardiac failure. Patients were classified according to tertile of baseline MPV. RESULTS: A total of 1206 patients with MI, including 934 men (77.4%) and 272 women (22.6%) were studied. The mean age of the study population was 56 years. At 1-year follow-up, 292 (28.57%) primary outcome occurred: cardiovascular mortality 78 (7.6%), fatal or non-fatal MI 153 (15.0%), stroke 30 (2.9%) and cardiac failure 128 (12.52%). Patients with the highest tertile MPV had higher primary outcome as compared with those with MPV in the lowest tertile (adjusted OR=2.31; 95% CI 1.60 to 3.35; p<0.001). Total mortality was also more in high-MPV group (adjusted OR 2.62; 95% CI 1.47 to 4.70; p<0.001). There were no significant changes in mean MPV values at admission from those at third month interval (9.15, (SD 0.99) vs 9.19 (SD 0.94); p=0.2). CONCLUSIONS: Elevated MPV was associated with worse outcome in patients with acute MI. Elevated MPV in these patients may be due to inherently large platelets. TRIAL REGISTRATION NUMBER: http://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=5485&EncHid=98036.61144&modid=1&compid=19; CTRI/2012/12/003222.
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Ranjith et al. (2016) conducted a cohort in Acute myocardial infarction (n=1,206). Highest tertile of baseline MPV vs. Lowest tertile of baseline MPV was evaluated on Composite of cardiovascular death, stroke, fatal or non-fatal MI and cardiac failure (adjusted OR 2.31, 95% CI 1.60 to 3.35, p=<0.001). High mean platelet volume (highest vs lowest tertile) in acute MI patients increased the risk of the primary composite cardiovascular outcome (adjusted OR 2.31; 95% CI 1.60-3.35; p<0.001).
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