Key result
Higher admission mean platelet volume linked to ~76% greater 30-day mortality after STEMI primary PCI.
Why the study?
Does high admission mean platelet volume predict impaired myocardial reperfusion and 30-day all-cause mortality in patients with STEMI undergoing primary PCI?
Observational (n=453)
Does high admission mean platelet volume predict impaired myocardial reperfusion and 30-day all-cause mortality in patients with STEMI undergoing primary PCI?
Increased admission mean platelet volume is an independent predictor of impaired myocardial reperfusion and short-term mortality in STEMI patients with successful epicardial reperfusion after primary PCI.
Answers are grounded in this paper and cite their sources.
May aid short-term risk stratification in STEMI; leaves open causal role and need for prospective validation.
Impaired myocardial reperfusion, defined angiographically by myocardial blush grade (MBG) 0 or 1, is associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to investigate the impact of admission mean platelet volume (MPV) on the myocardial reperfusion and 30-day all-cause mortality in patients with STEMI with successful epicardial reperfusion after primary percutaneous coronary intervention (PCI). A total of 453 patients with STEMI who underwent primary PCI within 12 h of symptoms onset and achieved thrombolysis in myocardial infarction (TIMI) 3 flow at infarct-related artery after PCI were enrolled and divided into two groups based on postinterventional MBG: those with MBG 2/3 and those with MBG 0/1. Admission MPV was measured before coronary angiography. The primary endpoint was all-cause mortality at 30 days. MPV was significantly higher in patients with MBG 0/1 than in patients with MBG 2/3 (10.38 ± 0.98 vs. 9.59 ± 0.73, P < 0.001). The cumulative 30-day all-cause mortality rate was significantly higher in the groups with high MPV and MBG 0/1 (6.8 vs. 1.5%, P = 0.005, 7.6 vs. 1.9%, P = 0.006, respectively). Multivariate logistic regression analysis demonstrated MPV was independently associated with postinterventional impaired myocardial reperfusion (odds ratio 2.684, 95% confidence interval 2.010-3.585, P < 0.001) and 30-day all-cause mortality (hazard ratio 1.763, 95% confidence interval 1.009-3.079, P = 0.046). Increased MPV on admission is an independent predictor of impaired myocardial reperfusion and short-term mortality in patients with STEMI with successful epicardial reperfusion after primary PCI. Admission MPV may be additive to conventional risk factors in patients with STEMI undergoing PCI.
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Lai et al. (2015) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=453). High admission mean platelet volume (MPV) vs. Low admission MPV was evaluated on All-cause mortality at 30 days (HR 1.763, 95% CI 1.009-3.079, p=0.046). Higher admission mean platelet volume was independently associated with increased 30-day all-cause mortality in STEMI patients undergoing primary PCI.
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