Sincer Isa, Gunes Yilmaz, Mansiroglu Asli Kurtar, Cosgun Mehmet, Aktas Gulali
Department of Cardiology, Abant Izzet Baysal University Hospital, Bolu, Turkey.
Department of Internal Medicine, Abant Izzet Baysal University Hospital, Bolu, Turkey.
Postepy Kardiol Interwencyjnej. 2018;14(3):263-269. doi: 10.5114/aic.2018.78329. Epub 2018 Sep 21.
The prognostic value of hematological indices in cardiovascular diseases and the association between these parameters and cardiovascular conditions have been established in the literature.
In this study, we aimed to investigate the relation of mean platelet volume (MPV), MPV to platelet ratio (MPR) and red cell distribution width (RDW) with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical coronary artery stenosis.
A total of 306 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: a group with adequate CCD ( = 214) and a group with impaired CCD ( = 92). Routine complete blood count and biochemical parameters were measured before coronary arteriography.
The MPV and MPR levels were significantly higher in the inadequate CCD group (10.5 ±1.8 fl vs. 8.7 ±1.9 fl, < 0.001 and 0.06 ±0.08 vs. 0.05 ±0.07, = 0.036). Patients with inadequate CCD had significantly higher RDW levels compared to patients with adequate CCD (15.5 ±1.7% vs. 15.0 ±1.9%, = 0.01). MPV and RDW were significantly associated with Rentrop collateral grading ( = -0.523, < 0.001 and = -0.239, < 0.001, respectively), whereas the association with MPR was not significant. An MPV value greater than 9.95 fl, determined with ROC curve analysis, had 71% sensitivity and 70% specificity in predicting inadequate CCD. An RDW greater than 14.3% has 71% sensitivity and 53% specificity in selecting patients with adequate CCD.
The present study suggests that MPV and MPR may be associated with the degree of collateral development in chronic stable CAD. However, the negative association of RDW with inadequate CCD, in combination with previous contradictory reports, raises a doubt about the possible value of RDW in stable CAD. Although these parameters may be affected by various conditions, a high MPV may lead clinicians to suspect possible inadequate collateral development in stable CAD patients.
血液学指标在心血管疾病中的预后价值以及这些参数与心血管疾病之间的关联已在文献中得到证实。
在本研究中，我们旨在探讨平均血小板体积（MPV）、MPV与血小板比率（MPR）以及红细胞分布宽度（RDW）与已确诊为严重冠状动脉狭窄的稳定型冠状动脉疾病（CAD）患者的冠状动脉侧支循环发育程度（CCD）之间的关系。
共纳入306例接受冠状动脉造影的稳定型心绞痛患者，并根据CCD的发育情况将其分为两组：CCD充分组（=214）和CCD受损组（=92）。在冠状动脉造影前测量常规全血细胞计数和生化参数。
CCD不充分组的MPV和MPR水平显著更高（10.5±1.8 fl对8.7±1.9 fl，<0.001；0.06±0.08对0.05±0.07，=0.036）。与CCD充分的患者相比，CCD不充分的患者RDW水平显著更高（15.5±1.7%对15.0±1.9%，=0.01）。MPV和RDW与Rentrop侧支分级显著相关（分别为=-0.523，<0.001；=-0.239，<0.001），而与MPR的关联不显著。通过ROC曲线分析确定，MPV值大于9.95 fl在预测CCD不充分方面具有71%的敏感性和70%的特异性。RDW大于14.3%在选择CCD充分的患者方面具有71%的敏感性和53%的特异性。
本研究表明，MPV和MPR可能与慢性稳定型CAD的侧支循环发育程度有关。然而，RDW与CCD不充分的负相关，结合先前相互矛盾的报道，引发了对RDW在稳定型CAD中可能价值的质疑。尽管这些参数可能受多种情况影响，但高MPV可能会使临床医生怀疑稳定型CAD患者可能存在侧支循环发育不充分情况。
