Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
The Renji Hospital of Shanghai Jiao Tong University, Shanghai, 200240, China.
BMC Cardiovasc Disord. 2019 May 29;19(1):128. doi: 10.1186/s12872-019-1115-2.
The association between mean platelet volume (MPV) and coronary plaque vulnerability in patients with non-ST-elevation ACS (NSTE-ACS) has not been investigated. We performed a retrospective study to evaluate the association between MPV and plaque vulnerability using optical coherence tomography (OCT).
Consecutive NSTE-ACS patients who underwent pre-intervention OCT examination in our center were included in this study. Features of coronary plaques in the culprit arteries were classified as rupture, nonrupture with thin-cap fibroatheroma (TCFA), and nonrupture and non-TCFA. ROC analyses were used to determine the predictive efficacy of MPV for plaque rupture, and multivariate logistic regression analysis was performed to evaluate the potential independent predictors of plaque vulnerability.
Overall, 94 patients were included in this study. We identified 17 patients with plaque rupture, 10 with nonrupture with TCFA, and 67 with nonrupture and non-TCFA. ROC analyses showed that MPV ≥ 10.5 fL was predictive of plaque rupture in NSTE-ACS patients. Univariate analyses indicated that patients with higher MPV (≥ 10.5 fL) had higher body mass index and poorer lipid profiles compared to those with lower MPV. Moreover, those with higher MPV had higher incidences of plaque rupture and thrombosis (both P < 0.05). Results of multivariate analyses showed that diabetes and higher platelet distribution width (PDW) were independent risk factors of TCFA (P = 0.032 and 0.046, respectively), while diabetes, higher BMI, higher PDW, and higher MPV were independent determinants of plaque rupture in our cohorts (P all < 0.05).
Higher MPV is independently associated with higher risk of plaque rupture as evidenced by OCT in our cohort of NSTE-ACS patients.
血小板平均体积（MPV）与非 ST 段抬高型急性冠脉综合征（NSTE-ACS）患者的冠脉斑块易损性之间的关联尚未得到研究。我们进行了一项回顾性研究，使用光学相干断层扫描（OCT）评估 MPV 与斑块易损性之间的关系。
本研究纳入了在我院接受介入治疗前 OCT 检查的连续 NSTE-ACS 患者。罪犯动脉中的冠脉斑块特征分为破裂、薄帽纤维粥样斑块（TCFA）非破裂和非 TCFA 非破裂。ROC 分析用于确定 MPV 对斑块破裂的预测效能，多变量 logistic 回归分析用于评估斑块易损性的潜在独立预测因素。
共有 94 例患者纳入本研究。我们发现 17 例患者存在斑块破裂，10 例患者存在 TCFA 非破裂，67 例患者存在非 TCFA 非破裂。ROC 分析显示，MPV≥10.5 fL 可预测 NSTE-ACS 患者的斑块破裂。单因素分析表明，MPV 较高（≥10.5 fL）的患者与 MPV 较低的患者相比，体重指数更高，血脂谱更差。此外，MPV 较高的患者斑块破裂和血栓形成的发生率更高（均 P<0.05）。多变量分析结果显示，糖尿病和较高的血小板分布宽度（PDW）是 TCFA 的独立危险因素（分别为 P=0.032 和 0.046），而糖尿病、较高的 BMI、较高的 PDW 和较高的 MPV 是本队列中斑块破裂的独立决定因素（均 P<0.05）。
在本 NSTE-ACS 患者队列中，较高的 MPV 与 OCT 检测到的斑块破裂风险增加独立相关。
