Dogan Abdullah, Aksoy Fatih, Icli Atilla, Arslan Akif, Varol Ercan, Uysal Bayram Ali, Ozaydin Mehmet, Erdogan Dogan
Cardiology Department, Medical School, Suleyman Demirel University, Isparta, Turkey.
Blood Coagul Fibrinolysis. 2012 Jun;23(4):324-30. doi: 10.1097/MBC.0b013e328352cb21.
We investigated the association of mean platelet volume (MPV) with culprit lesion severity and major cardiac outcomes (MCOs) in patients with acute coronary syndrome (ACS) with non-ST elevation (NSTE). This study included 344 patients with NSTE-ACS who had significant coronary stenosis at least 50%. They were divided into high MPV group (n = 109, upper tertile >9.9 fl) and low MPV group (n = 235, lower and mid tertile ≤ 9.9 fl) according to MPV values on admission. They were followed up for MCOs during 12 months. MCO consisted of the composite end-point of cardiac death, myocardial infarction (MI), recurrent angina or hospitalization. High MPV was independently associated with NSTE-MI [odds ratio (OR) 4.24, 95% confidence interval (CI) 2.52-7.15, P = 0.001] and severe culprit stenosis (≥ 80%) (OR 4.05, 95% CI 2.39-6.83, P = 0.001). MPV of 9.9 fl was predictive of severe culprit stenosis with a sensitivity of 73% and specificity of 77% (P < 0.001). At 12 months, MCO rate was higher in high MPV group than low MPV group (39 vs. 26%; P = 0.016). This difference resulted from death (6.4 vs. 2.1; P = 0.06) and recurrent angina (16.5 vs. 8.9%; P = 0.045). The MCO-free survival was worse in patients with high MPV than those with low MPV (61 vs. 74%; P = 0.01). In Cox regression analysis, high MPV remained an independent predictor of MCO (hazard ratio 1.52, 95% CI 1.01-2.29, P = 0.04) after adjusting for baseline characteristics. Elevated MPV was independently associated with NSTE-MI presentation and severity of culprit stenosis in NSTE-ACS patients. Moreover, MPV greater than 9.9 fl was predictive of a 12-month MCO.
我们研究了非ST段抬高型急性冠状动脉综合征（ACS）患者的平均血小板体积（MPV）与罪犯病变严重程度及主要心脏事件（MCO）之间的关联。本研究纳入了344例至少有50%显著冠状动脉狭窄的非ST段抬高型急性冠状动脉综合征患者。根据入院时的MPV值，将他们分为高MPV组（n = 109，上三分位数>9.9 fl）和低MPV组（n = 235，下三分位数和中三分位数≤9.9 fl）。对他们进行了为期12个月的MCO随访。MCO包括心源性死亡、心肌梗死（MI）、复发性心绞痛或住院的复合终点。高MPV与非ST段抬高型心肌梗死独立相关[比值比（OR）4.24，95%置信区间（CI）2.52 - 7.15，P = 0.001]以及严重罪犯病变狭窄（≥80%）（OR 4.05，95% CI 2.39 - 6.83，P = 0.001）。MPV为9.9 fl可预测严重罪犯病变狭窄，敏感性为73%，特异性为77%（P < 0.001）。12个月时，高MPV组的MCO发生率高于低MPV组（39%对26%；P = 0.016）。这种差异源于死亡（6.4%对2.1%；P = 0.06）和复发性心绞痛（16.5%对8.9%；P = 0.045）。高MPV患者的无MCO生存率低于低MPV患者（61%对74%；P = 0.01）。在Cox回归分析中，调整基线特征后，高MPV仍是MCO的独立预测因素（风险比1.52，95% CI 1.01 - 2.29，P = 0.04）。MPV升高与非ST段抬高型急性冠状动脉综合征患者的非ST段抬高型心肌梗死表现及罪犯病变狭窄严重程度独立相关。此外，MPV大于9.9 fl可预测12个月的MCO。
