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.
Ir J Med Sci. 2021 Aug;190(3):1095-1102. doi: 10.1007/s11845-021-02626-y. Epub 2021 Apr 24.
Despite the important role of some haematological parameters in tendency to thrombosis is known, their relationship with long-term stent thrombosis (ST) remains unclear.
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).
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.
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.
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.
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。
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。
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。
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。
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。