Ulucan Şeref, Keser Ahmet, Kaya Zeynettin, Katlandur Hüseyin, Özdil Hüseyin, Bilgi Mustafa, Ateş İsmail, Ülgen Mehmet Sıddık
Department of Cardiology, Mevlana University, Konya, Turkey.
Department of Cardiology, Mevlana University, Konya, Turkey.
Heart Lung Circ. 2016 Jan;25(1):29-34. doi: 10.1016/j.hlc.2015.05.017. Epub 2015 Jul 2.
The aim of the present study was to perform a preliminary evaluation of the potential association between platelet distribution width (PDW) and frequency of major adverse cardiovascular events (MACEs) development in an observational study of acute coronary syndrome (ACS) patients.
A total of 679 consecutive patients with ACS (498 (73.3%) males; mean age was 63.31±11.2 years; study population composed of 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris) subjected to primary percutaneous coronary intervention with transradial approach (TRA) were retrospectively enrolled to the study. Tertiles were formed based on PDW levels. The associations between PDW and in-hospital and long-term MACEs were analysed.
The frequencies of in-hospital instent thrombosis (P=0.05), long-term instent restenosis (P=0.005) and long-term total MACEs (P=0.008) were higher in tertiles having a high PDW value. In multivariate analyses, PDW was an independent predictor of in-hospital and long-term MACEs (odds ratio 1.081, 95% confidence interval 1.003-1.165; p=0.042). The projected Kaplan-Meier incidence of a MACEs in the PDW tertiles groups were 12.8%, 12.1%, and 21.6% at 40 months (respectively, p=0.003).
The pre-procedural PDW may be an independent predictor of both in-hospital and long-term adverse outcomes in patients with ACS.
本研究的目的是在一项针对急性冠状动脉综合征（ACS）患者的观察性研究中，对血小板分布宽度（PDW）与主要不良心血管事件（MACEs）发生频率之间的潜在关联进行初步评估。
共有679例连续的ACS患者（498例（73.3%）男性；平均年龄为63.31±11.2岁；研究人群包括320例急性心肌梗死患者和359例不稳定型心绞痛患者）接受了经桡动脉途径（TRA）的直接经皮冠状动脉介入治疗，并被回顾性纳入本研究。根据PDW水平分为三分位数组。分析了PDW与住院期间及长期MACEs之间的关联。
PDW值高的三分位数组患者的住院期间支架内血栓形成频率（P=0.05）、长期支架内再狭窄频率（P=0.005）和长期总MACEs频率（P=0.008）更高。在多变量分析中，PDW是住院期间及长期MACEs的独立预测因素（优势比1.081，95%置信区间1.003-1.165；P=0.042）。在40个月时，PDW三分位数组中MACEs的预计Kaplan-Meier发生率分别为12.8%、12.1%和21.6%（P=0.003）。
术前PDW可能是ACS患者住院期间及长期不良结局的独立预测因素。
