Díaz Juan Manuel, Boietti Bruno R, Vazquez Fernando J, Waisman Gabriel D, Giunta Diego H, Rojas Liliana Paloma, Peuchot Verónica, Posadas-Martínez María Lourdes
Internal Medicine Department, Hospital italiano de Buenos Aires, Universidad de Buenos Aires, Perón, Buenos Aires, Argentina.
Internal Medicine Department, Hospital Italiano de Buenos Aires, Universidad de Buenos Aires, Buenos Aires, Argentina.
Rev Med Chil. 2019 Feb;147(2):145-152. doi: 10.4067/s0034-98872019000200145.
Mean platelet volume (MPV) is a risk factor for cardiovascular and inflammatory diseases.
To evaluate the association between high MPV and 90-day mortality after an episode of venous thromboembolism (VTE).
Retrospective cohort of 594 patients with a median age of 73 years (58% women) with a first episode VTE, included in an institutional Thromboembolic Disease registry between 2014 and 2015. MPV values were obtained from the automated blood cell count measured at the moment of VTE diagnosis. Volumes ≥ 11 fL were classified as high. All patients were followed for 90 days to assess survival.
The main comorbidities were cancer in 221 patients (37%), sepsis in 172 (29%) and coronary artery disease in 107 (18%). Median MPV was 8 fl (8-9), brain natriuretic peptide 2,000 pg/ml (1,025-3,900) and troponin 40 pg/ml (19.5-75). Overall mortality was 20% (121/594) during the 90 days of follow-up. Thirty three deaths occurred within 7 days and 43 within the first month. The loss of patients from follow-up was 5% (28/594) at 90 days. Mortality among patients with high MP was 36% (23/63). The crude mortality hazard ratio (HR) for high MPV was 2.2 (95% confidence intervals (CI) 1.4-3.5). When adjusted for sepsis, oncological disease, heart disease, kidney failure and surgery, the mortality HR of high MPV was 2.4 (CI95% 1.5-3.9) in the VTE group, 2.3 (CI95% 1.5-4.4) in the deep venous thrombosis group, and 2.9 (CI95% 1.6 -5.6) in the pulmonary embolism group.
High MPV is an independent risk factor for mortality following an episode of VTE.
平均血小板体积（MPV）是心血管疾病和炎症性疾病的一个风险因素。
评估静脉血栓栓塞症（VTE）发作后高MPV与90天死亡率之间的关联。
对594例首次发生VTE的患者进行回顾性队列研究，这些患者的中位年龄为73岁（58%为女性），纳入了2014年至2015年机构血栓栓塞性疾病登记处。MPV值取自VTE诊断时自动血细胞计数结果。体积≥11 fL被归类为高值。所有患者随访90天以评估生存情况。
主要合并症为221例（37%）患有癌症，172例（29%）患有败血症，107例（18%）患有冠状动脉疾病。MPV中位数为8 fl（8 - 9），脑钠肽为2000 pg/ml（1025 - 3900），肌钙蛋白为40 pg/ml（19.5 - 75）。在90天的随访期间，总死亡率为20%（121/594）。7天内发生33例死亡，第一个月内发生43例死亡。90天时失访患者为5%（28/594）。高MPV患者的死亡率为36%（23/63）。高MPV的粗死亡率风险比（HR）为2.2（95%置信区间（CI）1.4 - 3.5）。在调整了败血症、肿瘤疾病、心脏病、肾衰竭和手术因素后，VTE组中高MPV的死亡率HR为2.4（CI95% 1.5 - 3.9），深静脉血栓形成组为2.3（CI95% 1.5 -
