Jiang P, Song Y, Xu J J, Ma Y L, Tang X F, Yao Y, Jiang L, Wang H H, Zhang X, Diao X L, Yang Y J, Gao R L, Qiao S B, Xu B, Yuan J Q
Department of Cardiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2017 Oct 24;45(10):862-866. doi: 10.3760/cma.j.issn.0253-3758.2017.10.010.
To evaluate the relationship between platelet distribution width(PDW) and the extent of coronary artery disease and 2-year outcome in patients received percutaneous coronary artery intervention(PCI) because of stable coronary artery disease(SCAD). We consecutively enrolled 4 293 patients who received PCI because of SCAD in Fuwai Hospital from Jan 2013 to Dec 2013, patients were followed up for 2 years. Patients were divided into three groups according to tertiles values of PDW as follows: PDW≤11.4%(1 402 patients), 11.4%<PDW≤12.9%(1 441 patients) and PDW>12.9% (1 450 patients). Major adverse cardiovascular and cerebrovascular events (MACCE) were defined as the occurrence of death, myocardial infarction, target vessel revascularization, intra stent thrombosis and stroke during follow-up. Multivariable logistic regression was used to evaluate the relationship between PDW and the extent of CAD. Multivariable Cox regression was used to evaluate the relationship between PDW and prognosis of SCAD patients. PDW was associated with diabetes mellitus, body mass index, red cell distribution width, mean platelet volume (MPV), platelet counts and glycosylated haemoglobin (<0.05), but not associated with age, sex, estimated glomerular filtration rate (>0.05). PDW was not correlated with the extent of CAD(=0.990), SYNTAX score(=0.721), no-reflow phenomenon after PCI(=0.978). Multivariable logistic regression also showed no relationship between PDW and extent of CAD (=0.994, 95% 0.961-1.029, =0.73). PDW was found to be an independent risk factor of 2-year cardiac death (=1.242, 95% 1.031-1.497, =0.022), but was not an independent risk factor of all-cause death and MACCE. PDW is not related with the extent of coronary artery disease. PDW is an independent risk factor of 2-year cardiac death, but is not an independent risk factor of all-cause death and MACCE in this patient cohort.
为评估血小板分布宽度（PDW）与因稳定型冠状动脉疾病（SCAD）接受经皮冠状动脉介入治疗（PCI）患者的冠状动脉疾病程度及2年预后之间的关系。我们连续纳入了2013年1月至2013年12月在阜外医院因SCAD接受PCI的4293例患者，并对其进行了2年的随访。根据PDW的三分位数将患者分为三组：PDW≤11.4%（1402例患者）、11.4%＜PDW≤12.9%（1441例患者）和PDW＞12.9%（1450例患者）。主要不良心血管和脑血管事件（MACCE）定义为随访期间发生的死亡、心肌梗死、靶血管血运重建、支架内血栓形成和中风。采用多变量逻辑回归评估PDW与CAD程度之间的关系。采用多变量Cox回归评估PDW与SCAD患者预后之间的关系。PDW与糖尿病、体重指数、红细胞分布宽度、平均血小板体积（MPV）、血小板计数和糖化血红蛋白相关（P＜0.05），但与年龄、性别、估计肾小球滤过率无关（P＞0.05）。PDW与CAD程度（r = 0.990）、SYNTAX评分（r = 0.721）、PCI术后无复流现象（r = 0.978）均无相关性。多变量逻辑回归也显示PDW与CAD程度无相关性（P = 0.994，95%CI 0.961 - 1.029，P = 0.73）。发现PDW是2年心脏死亡的独立危险因素（HR = 1.242，95%CI 1.031 - 1.497，P = 0.022），但不是全因死亡和MACCE的独立危险因素。PDW与冠状动脉疾病程度无关。在该患者队列中，PDW是2年心脏死亡的独立危险因素，但不是全因死亡和MACCE的独立危险因素。
