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血小板平均体积/血小板计数比值对 ST 段抬高型心肌梗死患者支架血栓形成的预测作用。

Mean platelet volume/platelet count ratio as a predictor of stent thrombosis in patients with ST-segment-elevation myocardial infarction.

机构信息

Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Tibbiye cad. 13, Haydarpasa, Istanbul, Turkey.

Department of Cardiology, Yalova State Hospital, Yalova, Turkey.

出版信息

Ir J Med Sci. 2021 Aug;190(3):1095-1102. doi: 10.1007/s11845-021-02626-y. Epub 2021 Apr 24.

Abstract

BACKGROUND

Despite the important role of some haematological parameters in tendency to thrombosis is known, their relationship with long-term stent thrombosis (ST) remains unclear.

AIMS

This study aimed to investigate the association between the mean platelet volume (MPV) to platelet count (PC) ratio and long-term ST and mortality in patients with ST-segment-elevation myocardial infarction (STEMI) treated successfully by primary percutaneous coronary intervention (pPCI).

METHODS

In a retrospective cohort study, according to their baseline MPV/PC ratios, 3667 consecutive STEMI patients undergoing pPCI were divided into three groups: tertile 1 (T1) (n = 1222, 0.357 ≥ MPV/PC ≥ 0.043), tertile 2 (T2) (n = 1222, 0.033 < MPV/PC < 0.043) and tertile 3 (T3) (n = 1223, 0.009 ≤ MPV/PC ≤ 0.032). Patients were followed up with for 5 years, focusing on ST and all-cause mortality outcomes.

RESULTS

Patients with T1 displayed a greater 5-year ST rate, including a 2.76-fold greater (95% confidence interval 1.68-10.33) rate than that of patients with T3, who had the lowest rates and were used as the reference group. Meanwhile, the 5-year mortality rate was similarly higher among patients with T1 by 1.72 times (95% confidence interval 1.33-2.22) relative to that among patients with T3. These significant relationships persisted even after adjustment for all confounders.

CONCLUSION

We found that higher MPV/PC ratios were associated with long-term ST and mortality. The MPV/PC ratio may constitute both a rapid and an easily obtainable parameter for identifying reliably high-risk patients who have undergone pPCI.

摘要

背景

尽管一些血液学参数在血栓形成倾向中起着重要作用,但它们与长期支架血栓形成(ST)的关系尚不清楚。

目的

本研究旨在探讨经皮冠状动脉介入治疗(pPCI)成功治疗的 ST 段抬高型心肌梗死(STEMI)患者平均血小板体积(MPV)与血小板计数(PC)比值与长期 ST 和死亡率的关系。

方法

在一项回顾性队列研究中,根据基线 MPV/PC 比值,将 3667 例连续接受 pPCI 的 STEMI 患者分为三组:第 1 三分位数(T1)(n=1222,0.357≥MPV/PC≥0.043)、第 2 三分位数(T2)(n=1222,0.033<MPV/PC<0.043)和第 3 三分位数(T3)(n=1223,0.009≤MPV/PC≤0.032)。患者随访 5 年,重点关注 ST 和全因死亡率结果。

结果

T1 组患者 5 年 ST 发生率较高,比 T3 组高 2.76 倍(95%置信区间 1.68-10.33),而 T3 组发生率最低,被用作参考组。同时,T1 组患者 5 年死亡率也显著高于 T3 组,相对风险比为 1.72(95%置信区间 1.33-2.22)。即使在调整所有混杂因素后,这些显著关系仍然存在。

结论

我们发现较高的 MPV/PC 比值与长期 ST 和死亡率相关。MPV/PC 比值可能既是一种快速且易于获得的参数,可用于可靠地识别接受 pPCI 的高危患者。

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