Tian Chunyang, Song Jia, He Dongxu, Wu Jiake, Sun Zhijun, Sun Zhaoqing
Department of Cardiology, Shengjing Hospital of China Medical University.
Int Heart J. 2018 Mar 30;59(2):286-292. doi: 10.1536/ihj.17-212. Epub 2018 Mar 20.
Increased mean platelet volume (MPV) has been associated with adverse clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). We aim to assess whether MPV/platelet count (MPV/PC) ratio is a useful marker to predict long-term prognosis in patients with STEMI undergoing PCI. Moreover, the prognostic accuracy of MPV/PC ratio is compared with MPV. 962 consecutive patients with STEMI treated with P-PCI were considered. According to the admission MPV/PC values, the population was divided into two groups: high MPV/PC group (n = 320, MPV/PC ≥ 0.055) and low MPV/PC group (n = 642, MPV/PC < 0.055). Multivariate analysis showed that high MPV/PC was an independent predictor of major adverse cardiovascular event (MACE; hazard ratio [HR]: 1.121, 95% confidence interval [CI]: 1.056-1.190, P < 0.01), all-cause mortality (HR: 1.109, 95% CI: 1.016-1.209, P = 0.020), cardiac mortality (HR: 1.141, 95% CI: 1.038-1.253, P = 0.006), nonfatal myocardial reinfarction (HR: 1.148, 95% CI: 1.044-1.262, P = 0.004), and unplanned repeat revascularization (HR: 1.073, 95% CI: 1.007-1.144, P = 0.030), respectively. MPV/PC ratio has good accuracy for predicting MACE (the area under the receiver-operating characteristic curve: 0.764), and the cut-off value was 0.054 with a sensitivity of 0.813 and a specificity of 0.662. The discriminatory performance of MPV/PC ratio was better than MPV for predicting MACE (MPV/PC ratio versus MPV: z = 2.285, P = 0.022), in patients with STEMI undergoing P-PCI. MPV/PC ratio is able to but better than MPV to predict long-term adverse outcomes in patients with STEMI undergoing P-PCI.
在接受经皮冠状动脉介入治疗（PCI）的ST段抬高型心肌梗死（STEMI）患者中，平均血小板体积（MPV）增加与不良临床结局相关。我们旨在评估MPV/血小板计数（MPV/PC）比值是否是预测接受PCI的STEMI患者长期预后的有用标志物。此外，将MPV/PC比值的预后准确性与MPV进行比较。研究纳入了962例连续接受急诊PCI治疗的STEMI患者。根据入院时的MPV/PC值，将患者分为两组：高MPV/PC组（n = 320，MPV/PC≥0.055）和低MPV/PC组（n = 642，MPV/PC < 0.055）。多因素分析显示，高MPV/PC是主要不良心血管事件（MACE；风险比[HR]：1.121，95%置信区间[CI]：1.056 - 1.190，P < 0.01）、全因死亡率（HR：1.109，95% CI：1.016 - 1.209，P = 0.020）、心源性死亡率（HR：1.141，95% CI：1.038 - 1.253，P = 0.006）、非致死性心肌再梗死（HR：1.148，95% CI：1.044 - 1.262，P = 0.004）和计划外重复血运重建（HR：1.073，95% CI：1.007 - 1.144，P = 0.030）的独立预测因子。MPV/PC比值对MACE具有良好的预测准确性（受试者工作特征曲线下面积：0.764），截断值为0.054，敏感性为0.813，特异性为0.662。在接受急诊PCI的STEMI患者中，MPV/PC比值预测MACE的鉴别性能优于MPV（MPV/PC比值与MPV比较：z = 2.285，P = 0.022）。MPV/PC比值能够预测接受急诊PCI的STEMI患者的长期不良结局，且优于MPV。
