Relationship of mean platelet volume to severity of coronary atherosclerosis in non-ST-segment myocardial infarction

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background Platelets play a crucial role in thrombotic mechanism. Mean platelet volume (MPV) is primarily indicator of platelet activation and its measurement is easy and time-effective. The MPV is associated with adverse cardiac events in coronary artery disease. However, limited data are available to assess the relationship of MPV to severity of coronary atherosclerosis through multiple indicators including SYNTAX and GENSINI scores and multivessel disease (MVD) in non-ST-segment elevation myocardial infarction (NSTEMI). Objective We tested the association of MPV to severity of coronary atherosclerosis via multiple indicators in NSTEMI. Methods Ninety-three newly diagnosed NSTEMI patients (male 80.6% male and mean age 60.1 ± 12.3) were prospectively enrolled those who underwent first-time coronary angiography. The MVD defined as having stenosis >70% in >1 coronary vessels and clinical risk scores including SYNTAX and GENSINI were calculated to stratify coronary atherosclerosis severity. These indicators were sub-categorized into low risk (score <23) versus intermediate-high risk (score ³23) SYNTAX and GENSINI scores and MVD versus single vessel disease. The MPV was obtained from complete blood count analysis prior to coronary angiography. Results Patients with intermediate-high risk SYNTAX (P = 0.001) and GENSINI (P = 0.002) scores had higher MPV values as compared to low risk. The higher MPV was also observed in in MPV than single vessel disease (P = 0 .017). The MPV was positively correlated with SYNTAX score (r = 0.281, P = 0.006, Spearmen’s Correlation), GENSINI (r = 0.219, P = 0.035, Spearmen’s Correlation), and MVD (r = 0.243, P = 0.019, Spearmen’s Correlation). Using logistic regression analysis after adjustment of traditional risk factors, we observed MPV remained independently associated with intermediate-high risk SYNTAX [odds ratio (OR): 0.881(95% confidence interval (Cl): 0.247-1.516), P = 0.006) and GENSINI scores [OR: 0.782(95%Cl: 0.131-1.434), P = 0.019) and MVD [OR: 0.718(95%Cl: 0.027-1.409), P = 0.042]. Operating characteristic curves (AUC) for MPV also evaluated intermediate-high SYNTAX score [AUC: 0.696(95%Cl: 0.587-0.804), P = 0.001) and GENSINI score [AUC: 0.694(95%Cl: 0.062-0.851), P = 0.003] and MVD [AUC: 0.660(95% Cl: 0.541-0.779), P = 0.020]. Conclusions We studied a positive relationship of MPV with high coronary severity through multiple indicators including SYNTAX, GENSINI and MVD in NSTEMI patients.