Lin Yangyi, Chen Xia, Xu Xiangdong
Coron Artery Dis. 2019 Dec;30(8):615-620. doi: 10.1097/MCA.0000000000000747.
Approximately 50% of patients with stable angina have coronary artery disease (CAD) on coronary angiography. The mean platelet volume (MPV) has been proposed as a marker that reflects platelet size and reactivity. This study investigated the predictive value of high MPV in patients with stable angina for diagnosing stable CAD.
A total of 491 patients with chest pain who underwent selective coronary angiography for suspected CAD were enrolled. The patients were divided into the CAD group and non-CAD group according to angiography. All demographic, laboratory, and angiographic data were collected.
Patients with MPV in the highest tertile were more likely to have CAD (66.9 vs. 51.0 vs. 35.7% for the highest, middle, and lowest tertiles; P = 0.001), had lower platelet counts (186 ± 48 vs. 199 ± 52 vs. 223 ± 63; P < 0.001), and had higher hemoglobin A1c levels (6.8 ± 1.5 vs. 6.5 ± 1.5 vs. 6.2 ± 1.1; P < 0.001). MPV had a positive correlation with hemoglobin A1c (r = 0.16; P < 0.001). Patients with CAD (n = 248) had higher MPV than those without CAD (n = 243) (11.0 ± 1.0 vs. 10.5 ± 0.9; P < 0.001). MPV was an independent predictor of CAD in patients with stable angina, with an adjusted odds ratio of 1.820 (95% confidence interval: 1.453-2.279; P < 0.001).
The presence of high MPV predicts the prevalence of CAD on coronary angiography in patients with stable angina, and this result may ultimately reduce unnecessary invasive coronary angiography.
约50%的稳定型心绞痛患者冠状动脉造影显示有冠状动脉疾病(CAD)。平均血小板体积(MPV)已被提议作为反映血小板大小和反应性的标志物。本研究调查了高MPV在稳定型心绞痛患者中对诊断稳定型CAD的预测价值。
共纳入491例因疑似CAD接受选择性冠状动脉造影的胸痛患者。根据造影结果将患者分为CAD组和非CAD组。收集所有人口统计学、实验室和造影数据。
MPV处于最高三分位数的患者患CAD的可能性更高(最高、中间和最低三分位数分别为66.9%、51.0%和35.7%;P = 0.001),血小板计数更低(186±48、199±52和223±63;P < 0.001),糖化血红蛋白水平更高(6.8±1.5、6.5±1.5和6.2±1.1;P < 0.001)。MPV与糖化血红蛋白呈正相关(r = 0.16;P < 0.001)。CAD患者(n = 248)的MPV高于无CAD患者(n = 243)(11.0±1.0与10.5±0.9;P < 0.001)。MPV是稳定型心绞痛患者CAD的独立预测因子,调整后的优势比为1.820(95%置信区间:1.453 - 2.279;P < 0.001)。
高MPV的存在可预测稳定型心绞痛患者冠状动脉造影中CAD的患病率,这一结果最终可能减少不必要的有创冠状动脉造影。