Extreme (highest and lowest tertiles) admission MPV/platelet ratios were associated with higher 4-year all-cause mortality after NSTEMI compared to the middle tertile (HR 1.951; 95% CI 1.032-3.687).
Cohort (n=619)
Does the admission MPV/platelet ratio predict 4-year all-cause mortality in patients with NSTEMI?
The admission MPV/platelet ratio is a significant predictor of 4-year all-cause mortality after NSTEMI, with both high and low extremes associated with worse outcomes compared to intermediate values.
Hazard Ratio: 1.951 (95% CI 1.032–3.687)
p-value: p=< 0.0396
Previous studies reported an association between elevated mean platelet volume (MPV) and post-myocardial infarction mortality. This study explores the association between long-term mortality after non-ST-segment elevation myocardial infarction (NSTEMI) and the peripheral blood platelet indices (i.e., the mean platelet volume (MPV), platelet count, and the MPV/platelet (MPV/P) ratio). Two physicians independently reviewed the data of 619 NSTEMI patients. The blood samples were drawn and analyzed within 1 h of admission, the second, and the last hospital days. Patients were stratified into equal tertiles according to the platelet count, MPV, and MPV/platelet ratio. The primary outcome, 4-year all-cause mortality, was compared among the platelet indices tertile models. According to MPV, platelet count, and MPV/platelet ratio tertile models, there was a trend of higher 4-year mortality for the lower and upper tertiles in comparison to the middle tertiles. However, only the admission MPV/platelet ratio tercile model was statistically significant for predicting the 4-year mortality. The mortality rate of the highest MPV/platelet (48/207 (23%)) and the lowest (41/206 (20%)) tertiles were significantly higher than the middle tertile (19/206 (9%)), p = 0.0004 by the chi-squared test. After adjusting for Global Registry of Acute Coronary Events, the patients in the combined first and third MPV/P tertiles had higher mortality in reference to those in the middle MPV/P tercile (hazard ratio 1.951, confidence interval 1.032-3.687, and p < 0.0396). Our novel finding is that the MPV/platelet ratio is superior to the MPV alone in predicting long-term mortality after NSTEMI. We suggest that using this ratio will magnify any existing relationship between platelet indices and mortality post-NSTMI. Further studies are needed to confirm our finding.
Azab et al. (Thu,) conducted a cohort in non-ST-segment elevation myocardial infarction (NSTEMI) (n=619). High or low admission MPV/platelet ratio (first and third tertiles) vs. Middle MPV/platelet ratio tertile was evaluated on 4-year all-cause mortality (HR 1.951, 95% CI 1.032-3.687, p=< 0.0396). Extreme (highest and lowest tertiles) admission MPV/platelet ratios were associated with higher 4-year all-cause mortality after NSTEMI compared to the middle tertile (HR 1.951; 95% CI 1.032-3.687).