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血小板体积参数作为主动脉瓣和二尖瓣置换患者瓣膜血栓形成风险的预测指标

Platelet Volume Parameters as Predictors of Valvular Thrombosis Risk in Patients with Aortic and Mitral Valve Replacement.

作者信息

Pourbashash Boshra, Eftekhar Seyed Parsa, Ahmadi Pooria, Jalali Arash, Hosseinsabet Ali, Badalabadi Reza Mohseni

机构信息

Cardiovascular Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.

Department of Cardiovascular Diseases, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Clin Appl Thromb Hemost. 2025 Jan-Dec;31:10760296241311268. doi: 10.1177/10760296241311268.

Abstract

Percutaneous valve implantation or surgical replacement with mechanical or biological valves are standard therapies for severe valvular heart diseases. Prosthetic valve thrombosis, though rare, is a serious complication, particularly with mechanical prostheses. This study aimed to investigate the predictive value of platelet volume parameters, including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-large cell ratio (P-LCR), for valvular thrombosis risk in patients undergoing valve replacement therapy. A retrospective cross-sectional study was conducted from May 2002 to May 2020, involving 108 patients with a history of mitral or aortic valve replacement and valvular thrombosis, and 216 controls with a history of valve surgery without valvular malfunction. PDW was significantly associated with an increased risk of thrombosis after adjusting for confounders, while MPV showed a clinical difference but did not reach statistical significance. P-LCR did not exhibit a significant association. These findings suggest PDW as a potential predictor of valvular thrombosis in such patients. The ease of measuring platelet volume parameters suggests their utility in routine hematological analysis for identifying patients at higher risk of valvular thrombosis post-replacement surgery. Further studies are warranted to validate these findings and explore additional laboratory markers, such inflammatory markers, for thrombotic risk assessment in this population.

摘要

经皮瓣膜植入术或使用机械瓣膜或生物瓣膜进行手术置换是严重瓣膜性心脏病的标准治疗方法。人工瓣膜血栓形成虽然罕见,但却是一种严重的并发症,尤其是对于机械瓣膜。本研究旨在探讨血小板体积参数,包括平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板大细胞比率(P-LCR),对接受瓣膜置换治疗患者瓣膜血栓形成风险的预测价值。对2002年5月至2020年5月进行的一项回顾性横断面研究,纳入了108例有二尖瓣或主动脉瓣置换及瓣膜血栓形成病史的患者,以及216例有瓣膜手术史但无瓣膜功能障碍的对照。在调整混杂因素后,PDW与血栓形成风险增加显著相关,而MPV显示出临床差异但未达到统计学意义。P-LCR未显示出显著相关性。这些发现表明PDW可作为此类患者瓣膜血栓形成的潜在预测指标。血小板体积参数测量简便,提示其在常规血液学分析中有助于识别置换手术后瓣膜血栓形成风险较高的患者。有必要进行进一步研究以验证这些发现,并探索其他实验室标志物,如炎症标志物,用于该人群的血栓形成风险评估。

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