İleri Mehmet, Kanat Selçuk, Orhan Gürdal, Bayır Pınar Türker, Gürsoy Havva Tuğba, Şahin Deniz, Çiçek Gökhan, Elalmış Özgür Uçar, Güray Ümit
Department of Cardiology, Ankara Numune Education and R esearch Hospital, Ankara, Turkey.
Cardiol J. 2015;22(1):37-43. doi: 10.5603/CJ.a2014.0021. Epub 2014 Mar 27.
Platelet activation appears to play an important role in thromboembolic complications of infective endocarditis (IE). Mean platelet volume (MPV) is a potentially useful marker of platelet activity and a quick and easy determinant of thrombotic risk. Hence the aim of this study was to investigate the baseline platelet volume indices (MPV and platelet distribution width [PDW]) in IE patients who developed embolic events in the follow-up period and who did not.
The study group consisted of 76 consecutive patients (female: 55, male: 21, mean age: 26 years old, ranged: 8-64 years) with definite IE according to Duke Criteria. Thirty four healthy subjects, who were age and gender adjusted, served as the control group. The mean duration of hospital stay was 44 days.
Among the IE patients, 13 (13/76, 17.1%) had major embolic events. Significantly larger vegetations were observed in patients with embolic events as compared to non-embolic group (1.4 vs. 1.0 cm, p = 0.03). MPV at hospital admission was higher in patients who had embolic events in the follow-up period compared to both those who did not and the control subjects (10.62 ± 1.13 vs. 9.25 ± 0.97 and 8.93 ± 0.82 fL, p < 0.001, respectively). Similarly, the patients with embolic events had increased PDW compared to the non-embolic ones and the control group (16.31 ± 2.42 vs. 14.35 ± 1.97 and 14.04 ± 1.82%, p < 0.001, respectively).
The present study demonstrated that IE patients with embolic events had increased MPV and PDW values, compared to non-embolics. Future prospective studies with standardized measurements may clarify the clinical role of platelet volume indices in thrombo-embolic complications of IE.
血小板活化似乎在感染性心内膜炎（IE）的血栓栓塞并发症中起重要作用。平均血小板体积（MPV）是血小板活性的一个潜在有用指标，也是血栓形成风险的一个快速且简便的决定因素。因此，本研究的目的是调查在随访期间发生栓塞事件和未发生栓塞事件的IE患者的基线血小板体积指标（MPV和血小板分布宽度[PDW]）。
研究组由76例根据杜克标准确诊为IE的连续患者组成（女性55例，男性21例，平均年龄26岁，范围8 - 64岁）。34名年龄和性别匹配的健康受试者作为对照组。平均住院时间为44天。
在IE患者中，13例（13/76，17.1%）发生了主要栓塞事件。与非栓塞组相比，栓塞事件患者观察到明显更大的赘生物（1.4 vs. 1.0 cm，p = 0.03）。随访期间发生栓塞事件的患者入院时的MPV高于未发生栓塞事件的患者和对照组（分别为10.62±1.13 vs. 9.25±0.97和8.93±0.82 fL，p < 0.001）。同样，与非栓塞患者和对照组相比，发生栓塞事件的患者PDW增加（分别为16.31±2.42 vs. 14.35±1.97和14.04±1.82%，p < 0.001）。
本研究表明，与非栓塞患者相比，发生栓塞事件的IE患者MPV和PDW值升高。未来采用标准化测量的前瞻性研究可能会阐明血小板体积指标在IE血栓栓塞并发症中的临床作用。
