Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Shizuoka, Japan.
Department of Cardiovascular Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Atherosclerosis. 2018 Oct;277:108-112. doi: 10.1016/j.atherosclerosis.2018.08.048. Epub 2018 Aug 31.
Although an elevated mean platelet volume (MPV) has been associated with poor clinical outcomes after acute coronary syndrome (ACS), the association between MPV and long-term outcomes in patients with stable coronary artery disease (CAD) remains uncertain. We aimed to investigate the impact of pre-procedural MPV levels in patients following elective percutaneous coronary intervention (PCI).
We studied 2872 stable CAD patients who underwent their first PCI and who had available data on pre-procedural MPV between 2002 and 2016. Patients were divided into quartiles based on their MPV. The incidences of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, were evaluated.
The median MPV was 10.4 fL (interquartile range: 9.8-11.0). During a median follow-up of 5.6 years, 498 (17.3%) MACE were identified, with a cumulative incidence significantly higher in the lowest MPV group than in other groups (p < 0.01). After adjustment for platelet count and the other cardiovascular risk factors, the lowest MPV group had a significantly higher risk of MACE compared with the highest MPV groups (hazard ratio: 1.43, 95% confidence interval 1.10-1.86, p = 0.009). Decreasing MPV as a continuous variable was associated with the incidence of MACE (hazard ratio: 1.16 per 1 fL decrease, 95% confidence interval 1.04-1.30, p = 0.007).
Contrary to previous studies on ACS patients, this study showed that a low MPV was associated with worse clinical outcomes among stable CAD patients.
虽然平均血小板体积（MPV）升高与急性冠状动脉综合征（ACS）后不良临床结局相关，但在稳定性冠状动脉疾病（CAD）患者中，MPV 与长期结局的关系仍不确定。我们旨在研究择期经皮冠状动脉介入治疗（PCI）后患者的术前 MPV 水平对其的影响。
我们研究了 2872 例稳定性 CAD 患者，他们在 2002 年至 2016 年间首次接受 PCI 治疗，并且有术前 MPV 的相关数据。根据 MPV 将患者分为四组。评估了主要不良心脏事件（MACE）的发生率，包括全因死亡和非致死性心肌梗死。
中位数 MPV 为 10.4 fL（四分位间距：9.8-11.0）。在中位数为 5.6 年的随访期间，有 498 例（17.3%）发生 MACE，最低 MPV 组的累积发生率明显高于其他组（p<0.01）。在校正血小板计数和其他心血管危险因素后，最低 MPV 组的 MACE 风险显著高于最高 MPV 组（风险比：1.43，95%置信区间 1.10-1.86，p=0.009）。MPV 连续变量降低与 MACE 的发生相关（风险比：每降低 1 fL 为 1.16，95%置信区间 1.04-1.30，p=0.007）。
与 ACS 患者的先前研究相反，本研究表明，在稳定性 CAD 患者中，低 MPV 与更差的临床结局相关。
