Medical University of L odz, Lodz, Poland.
Cardiol J. 2013;20(5):491-8. doi: 10.5603/CJ.2013.0134.
Mean platelet volume (MPV) is a strong predictor of impaired angiographic reperfusion and 6-month mortality in ST-elevation myocardial infarction (MI) treated with primary percutaneous coronary intervention (PCI). No data is available for other platelet volume indices: platelet distribution width (PDW) and platelet large cell ratio (P-LCR). The aim was to assess the impact of 3 platelet volume indices on long-term prognosis in patients treated with primary PCI in acute MI.
This prospective study enrolled 538 patients who underwent primary PCI in acute MI. Admission blood samples were measured for MPV, PDW, and P-LCR. The patients were followed-up a mean period of 26 ± 11 months with regard to cardiac death, non-fatal reinfarction, re-PCI or coronary artery bypass grafting.
Kaplan-Meier survival analysis showed a significantly higher 26-month mortalityrate in patients with high MPV (≥ 11.7 fL) than in those with low MPV (< 11.7 fL) (14.6% vs. 5.5%, p = 0.0008). Similar findings were related to high P-LCR (≥ 38.1%) vs. low P-LCR (< 38.1%) - mortality 13.8% vs. 5.8%, p = 0.0025. Higher PDW values (≥ 16 fL) correlated with higher mortality rate as compared to PDW < 16 fL (17.4% vs. 6.3%, p = 0.0012). PDW was found to be an independent prognostic factor for cardiac mortality and composite endpoint.
Mean platelet volume, platelet distribution width and platelet large cell ratio measured on admission are strong, independent prognostic factors in PCI-treated acute MI.
血小板平均体积（MPV）是经皮冠状动脉介入治疗（PCI）治疗的 ST 段抬高型心肌梗死（MI）患者血管造影再灌注受损和 6 个月死亡率的强有力预测因子。尚无其他血小板体积指数（血小板分布宽度 [PDW] 和血小板大细胞比 [P-LCR]）的数据。目的是评估 3 种血小板体积指数对接受急性 MI 直接 PCI 治疗的患者的长期预后的影响。
这项前瞻性研究纳入了 538 名接受急性 MI 直接 PCI 的患者。入院时采集血样，测量 MPV、PDW 和 P-LCR。患者平均随访 26±11 个月，随访终点为心脏死亡、非致死性再梗死、再次 PCI 或冠状动脉旁路移植术。
Kaplan-Meier 生存分析显示，MPV 较高（≥11.7 fL）的患者 26 个月死亡率明显高于 MPV 较低（<11.7 fL）的患者（14.6% vs. 5.5%，p=0.0008）。与 P-LCR 较高（≥38.1%）相比，P-LCR 较低（<38.1%）也存在类似的相关性——死亡率分别为 13.8%和 5.8%，p=0.0025。与 PDW<16 fL 相比，PDW 较高（≥16 fL）与更高的死亡率相关（17.4% vs. 6.3%，p=0.0012）。PDW 是心脏死亡率和复合终点的独立预后因素。
入院时测量的血小板平均体积、血小板分布宽度和血小板大细胞比是 PCI 治疗急性 MI 的强有力的独立预后因素。
