Key result
Mean platelet volume was identified as an independent predictor of the left anterior descending artery being the culprit vessel in patients with NSTEMI (OR 0.46; 95% CI 0.27-0.78).
Why the study?
Unlike STEMI, ECG cannot identify the culprit vessel in NSTEMI, prompting evaluation of the association between mean platelet volume and LAD culprit lesions.
Is mean platelet volume associated with the left anterior descending artery being the culprit vessel in patients with NSTEMI?
Cross-Sectional (n=349)
Is mean platelet volume associated with the left anterior descending artery being the culprit vessel in patients with NSTEMI?
Mean platelet volume may serve as a useful, accessible biomarker to help identify the left anterior descending artery as the culprit vessel in patients presenting with NSTEMI.
May support MPV as NSTEMI biomarker; leaves open prospective validation before clinical use.
Background: Among acute coronary patients, the ratio of non ST-elevation myocardial infarction (NSTEMI) is increasing and according to recent studies, less than 30% of myocardial infarctions (MIs) are due to ST-elevation myocardial infarction (STEMI). Unlike STEMI, in NSTEMI the ECG is not able to identify the culprit vessel. Objectives: In this study, we aimed to evaluate the association of mean platelet volume (MPV) and NSTEMI due to left anterior descending lesion. Methods: In this cross sectional study 349 patients with NSTEMI were included. Major cardiac risk factors (cigarette, diabetes mellitus (DM), hypertension (HTN), hyperlipidemia (HLP), angiographic findings, and drug history of patients were extracted from patients’ medical files. Then the MPV in complete blood count results and angiography findings were analyzed for any association. According to culprit lesions patients were divided into left anterior descending (LAD) and non-LAD groups. Results: There was a significant difference between the two groups (LAD vs. non-LAD) according to platelet count (P = 0.014), MPV (P = 0.001), HLP (0.024) and DM (0.048). Multivariate regression model has shown the MPV (OR = 0.46, 95%CI = 0.27 - 0.78) and DM (OR = 0.18, 95%CI = 0.06 - 0.54) as independent risk factors for NSTEMI due to LAD lesion. The significant positive correlation was also seen between MPV and left ventricle ejection fraction (LVEF) (r = 0.22, P = 0.006). The area under the curve (AUC) of MPV for predicting LAD culprit lesion was calculated as 69% (P < 0.0001). At cut off point of 9.15, has sensitivity and specificity of MPV for predicting LAD as culprit vessel was 100% and 30% respectively. Conclusions: In NSTEMI patients MPV might be a good tool to differentiate patients with LAD as culprit vessel.
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Separham et al. (2020) conducted a cross-sectional in Non ST-elevation myocardial infarction (NSTEMI) (n=349). Mean platelet volume (MPV) was evaluated on NSTEMI due to left anterior descending (LAD) lesion (OR 0.46, 95% CI 0.27 - 0.78). Mean platelet volume was identified as an independent predictor of the left anterior descending artery being the culprit vessel in patients with NSTEMI (OR 0.46; 95% CI 0.27-0.78).
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