Abstract
BackgroundThe prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients.MethodsFour hundred eighty consecutive STEMI patients were enrolled in this retrospective study. The patients were grouped as survivors (n = 370) or non-survivors (n = 110). MPV at admission, and at 48–72 h was evaluated. Change in MPV (MPV at 48–72 h minus MPV on admission) was defined as ΔMPV.ResultsAt follow-up, long-term mortality was 23%. The non-survivors had a high ΔMPV than survivors (0.37 (− 0.1–0.89) vs 0.79 (0.30–1.40) fL, p < 0.001). A high ΔMPV was an independent predictor of all cause mortality ((HR: 1.301 [1.070–1.582], p = 0.008). Morever, for long-term mortality, the AUC of a multivariable model that included age, LVEF, Killip class, and history of stroke/TIA was 0.781 (95% CI:0.731–0.832, p < 0.001). When ΔMPV was added to a multivariable model, the AUC was 0.800 (95% CI: 0.750–0.848, z = 2.256, difference p = 0.0241, Fig. 1). Also, the addition of ΔMPV to a multivariable model was associated with a significant net reclassification improvement estimated at 24.5% (p = 0.027) and an integrated discrimination improvement of 0.014 (p = 0.0198).ConclusionsRising MPV during hospitalization in STEMI patients treated with pPCI was associated with long-term mortality.
Highlights
Platelets (PLT) play an important role in in both initiation and progression of acute coronary syndromes (ACS) [1, 2]
When Change in mean platelet volume (ΔMPV) was added to a multivariable model, the area under the curve (AUC) was 0.800
The addition of ΔMPV to a multivariable model was associated with a significant net reclassification improvement estimated at 24.5% (p = 0.027) and an integrated discrimination improvement of 0.014 (p = 0.0198)
Summary
Platelets (PLT) play an important role in in both initiation and progression of acute coronary syndromes (ACS) [1, 2]. Mean platelet volume (MPV) is an indicator of platelet activation [6]. Numerous studies have been shown that the increased MPV at admission was associated with long-term mortality in patients with ACS [8,9,10]. An in-hospital increase in MPV after admission was found to be predictor of mortality in both non-ST segment elevation myocardial infarction and critical patients [11, 12]. The prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients
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