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Galimzhanov A, Tun HN, Sabitov Y, Perone F, Kursat TM, Tenekecioglu E, Mamas MA. The prognostic value of mean platelet volume in patients with coronary artery disease: An updated systematic review with meta‐analyses. Eur J Clin Invest 2024. [DOI: 10.1111/eci.14295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Accepted: 07/23/2024] [Indexed: 10/15/2024]
Abstract
AbstractBackgroundMean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD.MethodsPubMed, Web of Science, and Scopus were the major databases used for literature search. The risk of bias was assessed using the quality in prognostic factor studies. We used random‐effects pairwise analysis with the Knapp and Hartung approach supported further with permutation tests and prediction intervals (PIs).ResultsWe identified 52 studies with 47,066 patients. A meta‐analysis of nine studies with 14,864 patients demonstrated that one femtoliter increase in MPV values was associated with a rise of 29% in the risk of long‐term mortality (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.22–1.37) in CAD as a whole. The results were further supported with PIs, permutation tests and leave‐one‐out sensitivity analyses. MPV also demonstrated its stable and significant prognostic utility in predicting long‐term mortality as a linear variable in patients treated with percutaneous coronary intervention (PCI) and presented with acute coronary syndrome (ACS) (HR 1.29, 95% CI 1.20–1.39, and 1.29, 95% CI 1.19–1.39, respectively).ConclusionThe meta‐analysis found robust evidence on the link between admission MPV and the increased risk of long‐term mortality in patients with CAD patients, as well as in patients who underwent PCI and patients presented with ACS.
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Affiliation(s)
- Akhmetzhan Galimzhanov
- Department of Propedeutics of Internal Disease Semey Medical University Semey Kazakhstan
- Keele Cardiovascular Research Group Keele University Keele UK
| | - Han Naung Tun
- Larner College of Medicine University of Vermont Burlington Vermont USA
| | | | - Francesco Perone
- Cardiac Rehabilitation Unit Rehabilitation Clinic “Villa delle Magnolie” Caserta Italy
| | - Tigen Mustafa Kursat
- Faculty of Medicine, Department of Cardiology Marmara University Istanbul Turkey
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Yuksek İhtisas Training and Research Hospital Health Sciences University Bursa Turkey
- Department of Cardiology, Erasmus MC, Thorax Center Erasmus University Rotterdam the Netherlands
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group Keele University Keele UK
- National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre Birmingham UK
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Galimzhanov A, Tenekecioglu E, Rustamova F, Tun HN, Mamas MA. The Prognostic Utility of Mean Platelet Volume in Patients With Acute Coronary Syndrome: A Systematic Review With Meta-Analyses. Angiology 2022; 73:734-743. [PMID: 35062842 DOI: 10.1177/00033197211070908] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Mean platelet volume (MPV) is a hematological index that is routinely measured in clinical settings. Although many studies have been conducted to investigate the prognostic significance of MPV in acute coronary syndromes (ACS), the findings have been inconsistent. The goal of this study was to systematically review all current evidence on the association between admission MPV and clinical outcomes after ACS. PubMed, Scopus, Web of Science, and other databases were searched. The primary endpoints were major adverse cardiovascular events (MACE) and mortality. We applied a Knapp and Hartung adjustment, prediction interval calculations and permutation tests during pairwise meta-analyses. A one-stage dose-response meta-analysis was also conducted. The meta-analysis consisted of 41 studies with 33443 participants. Mean platelet volume, as a continuous variable, was associated with the risk of long-term mortality (hazard ratio 1.33, 95% CI 1.19-1.48). After conducting permutation tests and calculation of prediction intervals, this association remained significant. The results for MACE were nonsignificant. Linear models were the best fitted models during dose-response meta-analyses, trends for nonlinearity were significant for long-term endpoints. Admission MPV was associated with long-term mortality in ACS patients, with nonlinear associations between MPV levels and long-term clinical outcomes.
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Affiliation(s)
- Akhmetzhan Galimzhanov
- Department of Cardiology and Interventional Arrhythmology, 373881Semey Medical University, Semey, Kazakhstan
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Education and Research Hospital Health Sciences University, Bursa, Turkey
| | - Farida Rustamova
- Department of Internal Disease, 186045Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Han Naung Tun
- Larner College of Medicine, 12352University of Vermont, Burlington, VT, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group Keele University, UK
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Vélez PA, Baldeón R L, Vélez-Paez JL. The behavior of Mean Platelet Volume in Sepsis in critical patients with and without sepsis. BIONATURA 2021. [DOI: 10.21931/rb/2021.06.02.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The mean platelet volume is an anatomical biomarker that has shown its usefulness in various cardiovascular and metabolic pathologies; in sepsis, it has been positioning itself as an indicator of mortality, easily accessible and immediately applicable when reported in the routine blood count. This study demonstrates the mean platelet volume's biological behavior in critical patients with sepsis compared with non-septic patients. An observational, longitudinal, prospective, monocentric cohort study was conducted in 250 patients treated at the intensive care unit of the Pablo Arturo Suárez Hospital, Quito- Ecuador, from January 2019 January 2020. A group of patients with sepsis (n = 125) and without infectious pathologies (n = 125) were studied. The inclusion criteria were patients over 18 years of age of both genders, diagnosed with sepsis or septic shock using SEPSIS 3 criteria, and patients without septic pathology. The mean platelet volume (MPV) of days 1, 2, and 3 were studied. Septic patients had a mean APACHE (18.74 SD 9.52) higher than the non-septic ones (11.93 SD 7.01) (p = < 0.000). The MPV was consistently higher in patients with sepsis than non-septic patients, but it reached statistical significance on day 3 (9.13 SD 1.55 vs. 8.66 SD 1.34, p=0.042). The MPV on day 3 presented a significant area under the curve (AUC =0.580) (CI. 0.500-0.661), where the cut-off point according to Youden's index was positive for sepsis if MPV≥ 9.85 femtoliter (fL) with OR=3.30 and p-value= 0.005. Likewise, lactate on admission showed an AUC of 0.625 (CI. 0.555-0.694), with a cut-off point ≥of 1.15 mmol / L, OR=2.51, and p=0.007. Age and hypertension did not show a multivariate relationship with the presence of sepsis. It was shown that MPV is higher in patients with sepsis compared to non-septic ones. This observation reaches significance on day 3. Additionally, elevated lactate at admission was also associated with a septic state. On the other hand, platelet count did not show the expected behavior.
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Affiliation(s)
| | - Lucy Baldeón R
- Facultad de Ciencias Médicas-Universidad Central del Ecuador Instituto de Investigación en Biomedicina Universidad Central del Ecuador
| | - Jorge Luis Vélez-Paez
- Servicio de Medicina Crítica-Hospital Pablo Arturo Suárez Facultad de Ciencias Médicas-Universidad Central del Ecuador
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Vélez-Paez JL, Velarde-Montero C, Irigoyen-Mogro E, Vélez-Páez P, Cifuentes-López P, Vélez JW, Albitres-Flores L, Barboza JJ. Volumen plaquetario medio como predictor de la mortalidad en pacientes con sepsis: revisión sistemática y metanálisis. INFECTIO 2020. [DOI: 10.22354/in.v24i3.861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introducción: El volumen medio plaquetario (VMP) es un biomarcador utilizado en el abordaje integral de la sepsis. Objetivo: Evaluar la asociación entre VMP con la mortalidad en pacientes con sepsis. Métodos: Se realizó una revisión sistemática de estudios observacionales en cinco bases de datos. Se analizó la mortalidad asociada con la sepsis; las intervenciones consideradas fueron VMP, APACHE y lactato sérico. Resultados: Respecto a la mortalidad asociada a sepsis, se encontró un valor significativo en la VMP a las 72 horas (200 fallecidos versus 654 no fallecidos; MD 0.83 IC95% 0.53-1.13, p= <0.0001, I2=72.9%); así como el valor de APACHE II (220 muertos frente a 604 no fallecidos; MD 0.81 IC95% 0.62-1.0, p= <0.0001, I2=32%). No se encontró significancia estadística para las demás variables clínicas. Conclusiones: El aumento de la VMP se asocia con mayor riesgo de mortalidad en pacientes con sepsis, especialmente después de 72 horas de evolución de las características clínicas.
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Karaman S, Coskun A. Do MCHC, MPV, and Procalcitonin Levels Determine Prognosis in Acute Coronary Syndrome? Emerg Med Int 2019; 2019:6721279. [PMID: 31396420 PMCID: PMC6668557 DOI: 10.1155/2019/6721279] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 05/27/2019] [Accepted: 06/16/2019] [Indexed: 02/08/2023] Open
Abstract
AIM Acute coronary syndrome (ACS) continues to be the main cause of mortality and morbidity globally. The aim was to assess serum procalcitonin (PCT), mean corpuscular hemoglobin concentration (MCHC) and mean platelet volume (MPV) levels in terms of complications after myocardial infarctus, triple vein coronary artery disease (TVCAD), and mortality prediction. MATERIAL AND METHOD This cross-sectional cohort study included 200 patients with ACS attending the emergency department of our hospital with chest pain and admitted to the cardiology clinic from January 2014 to December 2016. Patients were divided into 4 groups as inferior group, anterior group, NSTEMI group, and UA group according to diagnosis. These groups were compared in terms of complications occurring after MI, TVCAD, and mortality rates. RESULTS There were significant differences in terms of complications forming after ACS, TVCAD, and mortality. The inferior subgroup had high PCT and MCHC levels and was found to have more complications developing and mortality compared to other groups. Patients with high PCT and MPV values were identified to have higher mortality and TVCAD. In the anterior subgroup, ischemic heart failure was higher compared to the other groups. In the interior, anterior, and non-ST elevated myocardial infarctus (NSTEMI) groups, the 0-, 6-, and 12-hour cTnI values were significantly higher compared to the UA group, while the anterior group had a significantly higher 12-hour cTnI value compared to the NSTEMI group. Correlation analysis for PCT, MCHC, and MPV with complications developing after MI, mortality, and TVCAD found positive and statistically significant correlations. CONCLUSION High PCT, MCHC, and MPV levels in acute coronary syndrome may be beneficial predictive values in terms of complications that may develop, TVCAD, and mortality.
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Affiliation(s)
- Serhat Karaman
- 1Department of Emergency Medicine, Gaziosmanpasa University, Faculty of Medicine, Tokat, Turkey
| | - Abuzer Coskun
- 2Department of Emergency Medicine, Sivas State Hospital, Sivas, Turkey
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Saia F, Rapezzi C, Marrozzini C, Reggiani MLB, Palmerini T, Ortolani P, Melandri G, Rosmini S, Cinti L, Alessi L, Vagnarelli F, Villani C, Branzi A, Marzocchi A, Taglieri N. Prognostic significance of mean platelet volume on admission in an unselected cohort of patients with non ST-segment elevation acute coronary syndrome. Thromb Haemost 2017; 106:132-40. [DOI: 10.1160/th10-12-0821] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Accepted: 04/08/2011] [Indexed: 01/30/2023]
Abstract
SummaryMean platelet volume (MPV) has been proposed as a marker of platelet reactivity and cardiovascular risk. Its prognostic significance has not been thoroughly investigated in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). We included 1,041 consecutive patients with NSTE-ACS. Patients were divided in quartiles according to the MPV value on admission (fl) i.e. Q1<7.5; Q2=7.5–8.0; Q3=8.1–8.8; Q4≥8.9. The primary study endpoint was the composite of cardiovascular death and re-myocardial infarction (MI) at one year. Secondary study endpoints were individual cardiovascular death and re-MI. Patients in Q4 were older, had a higher prevalence of previous MI, peripheral artery disease and advanced Killip class compared to patients in Q1-Q3. Elevated MPV levels (Q4) was independently associated with gender, smoking status, platelet count and creatinine level. Overall, 210 patients (20.2%) reached the primary endpoint, 124 (12.1%) died from cardiovascular causes and 125 (12.0%) suffered from re-MI. On multivariable analysis patients in Q4 were at higher risk of primary endpoint (HR=1.41; 95%CI 1.06–1.89; p=0.02) whilst the association with cardiovascular death and re-MI was attenuated. MPV as continuous variable was independently associated with both primary endpoint (HR=1.19; 95%CI 1.06–1.33; p=0.003) and cardiovascular death (HR=1.23; 95%CI 1.06–1.42, p=0.006). The incorporation of MPV into a comprehensive model of risk significantly increased the likelihood ratio chi-square for prediction of both the composite endpoint (p=0.004) and cardiovascular death (p=0.009). Therefore, MPV may be useful to improve risk stratification in NSTE-ACS patients and should be included in future prospective studies evaluating the role of platelet function in promoting cardiovascular events.
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Ayer M, Menken İ, Yamak M, Ayer FA, Kırkızlar O, Burak Aktuğlu M. The Impact of Mean Platelet Volume (MPV) and JAK-2 Mutation on Thrombosis in Chronic Myeloproliferative Diseases. Indian J Hematol Blood Transfus 2017; 33:181-187. [PMID: 28596648 PMCID: PMC5442048 DOI: 10.1007/s12288-016-0685-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/17/2016] [Indexed: 02/02/2023] Open
Abstract
Thrombosis and bleeding are the main complications of chronic myeloproliferative diseases. Mean platelet volume (MPV) is an important indicator of the platelet activation. The aim of the present study was to assess the interrelationships between MPV, JAK-2 gene mutation and thromboembolic events in patients with ET and PV. Patients with ET (n = 60) and PV (n = 46) were compared to the secondary erythrocytosis group (n = 19); and a control group of age and sex matched healthy volunteers (n = 52). Besides demographic, clinical and laboratory data; thrombotic and hemorrhagic events were recorded for each patient. Platelet counts, MPV and JAK2 mutations were studied; and their relation with thromboembolic events were investigated using SPSS program for statistical analysis. There was no significant difference between groups regarding age (p = 0.188). Mean platelet count was significantly higher in ET group than other groups (p < 0.0001). Mean platelet count in PV group was significantly higher than control (p < 0.0001) and secondary erythrocytosis groups (p < 0.0001). In the ET group, MPV values were significantly lower than the control group and PV group. In the ET group, those with thromboembolia had lower platelet counts. There was no relation between MPV and thromboembolic event rate in PV, ET and secondary erithrocytosis groups; while no event was recorded in the control group. There was no relation between thromboembolic event rate and JAK 2 mutation. The association of JAK-2 mutation and high MPV especially in ET and PV groups does not contribute to the thromboembolic events.
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Affiliation(s)
- Mesut Ayer
- Department of Hematology, Haseki Training and Research Hospital, Millet Cd., Aksaray/Fatih, 34087 Istanbul, Turkey
| | - İlhan Menken
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Mehmet Yamak
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Fatma Aylin Ayer
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Onur Kırkızlar
- Department of Hematology, Medeniyet University Goztepe Training and Research Hospital, Istanbul, Turkey
| | - M. Burak Aktuğlu
- Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey
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8
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Usefulness of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients With Non-ST-Elevation Acute Coronary Syndromes. Am J Cardiol 2017; 119:192-196. [PMID: 27814786 DOI: 10.1016/j.amjcard.2016.09.042] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/27/2016] [Accepted: 09/27/2016] [Indexed: 11/23/2022]
Abstract
Acute coronary syndrome (ACS) is characterized by unstable plaque with thrombotic process involving central role of platelets. The diagnosis and prediction of significant coronary artery disease (CAD) in non-ST-elevation ACS (NSTE-ACS) can be challenging. The central role of platelets in acute atherothrombosis in NSTE-ACS spurred appreciable interest in the diagnostic and predictive role of platelet activity. Mean platelet volume (MPV) is one of the most promising laboratory markers in patients with CAD. This retrospective study was designed to investigate the diagnostic and predictive value of high MPV levels in patients with NSTE-ACS with significant CAD. A total of 213 patients (men 53%, mean age 61 ± 12.3 years) with NSTE-ACS were enrolled from 2011 to 2016 from 2 teaching hospitals. Patients' demographic, laboratory, and angiographic data were collected. Significant CAD was defined as ≥70% stenosis in at least 1 major coronary artery. Patients with high MPV (MPV ≥9 fl) had more significant CAD (55% vs 35%, p = 0.005), lower platelet count (204 ± 59 × 1,000/μl vs 246 ± 56 × 1,000/μl, p = 0.001), and higher HbA1c (6.9 vs 6.4, p = 0.02). Patients with significant CAD had higher MPV level (9.2 ± 1.07 vs 8.6 ± 1.03 fl, p = 0.001), higher MPV/platelet ratio (0.46 vs 0.40, p = 0.01), older age (64.5 ± 11 vs 59.2 ± 12 years, p = 0.02), and lower high-density lipoprotein level (42 ± 12 vs 47 ± 16, p = 0.01). Multivariate analysis showed that increased age, high MPV, high troponin, and low high-density lipoprotein levels were associated with significant CAD. Patients with high MPV along with high troponin level demonstrated a 4.8-fold increased risk for significant CAD compared to those with normal MPV and high troponin (odds ratio 4.8, 95% confidence interval 1.31 to 17.6, p = 0.001). In conclusion, considering high MPV in the context of elevated troponin level increases the predictive value of screening for significant CAD, and this result may help determine who is most likely to benefit from cardiac catheterization.
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Choi DH, Kang SH, Song H. Mean platelet volume: a potential biomarker of the risk and prognosis of heart disease. Korean J Intern Med 2016; 31:1009-1017. [PMID: 27776204 PMCID: PMC5094934 DOI: 10.3904/kjim.2016.078] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 10/04/2016] [Indexed: 01/01/2023] Open
Abstract
Platelets are essential for progression of atherosclerotic lesions, plaque destabilization, and thrombosis. They secrete and express many substances that are crucial mediators of coagulation, inflammation, and atherosclerosis. Mean platelet volume (MPV) is a precise measure of platelet size, and is routinely reported during complete blood count analysis. Emerging evidence supports the use of MPV as a biomarker predicting the risk of ischemic stroke in patients with atrial fibrillation, and as a guide for prescription of anticoagulation and rhythm-control therapy. In addition, MPV may predict the clinical outcome of percutaneous coronary intervention (PCI) in patients with coronary artery disease and indicate whether additional adjunctive therapy is needed to improve clinical outcomes. This review focuses on the current evidence that MPV may be a biomarker of the risk and prognosis of common heart diseases, particularly atrial fibrillation and coronary artery disease treated via PCI.
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Affiliation(s)
- Dong-Hyun Choi
- Department of Internal Medicine, Chosun University School of Medicine, Gwangju, Korea
- Correspondence to Dong-Hyun Choi, M.D. Department of Internal Medicine, Chosun University School of Medicine, 309 Pilmun-daero, Dong-gu, Gwangju 61452, Korea Tel: +82-62-220-3773 Fax: +82-62-222-3858 E-mail:
| | - Seong-Ho Kang
- Department of Laboratory Medicine, Chosun University School of Medicine, Gwangju, Korea
| | - Heesang Song
- Department of Biochemistry and Molecular Biology, Chosun University School of Medicine, Gwangju, Korea
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Li-Sha G, Peng C, Yue-Chun L. Recurrent acute coronary syndrome and restenosis after percutaneous coronary intervention in a patient with idiopathic thrombocytopenic purpura: a case report and literature review. BMC Cardiovasc Disord 2015; 15:101. [PMID: 26385102 PMCID: PMC4574573 DOI: 10.1186/s12872-015-0092-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 09/12/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Platelets play a pivotal role in the pathogenesis of acute coronary syndrome (ACS) and acute and chronic complications following percutaneous coronary intervention (PCI). Platelet inhibition is a cornerstone in the management of these patients. Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder characterized by premature platelet destruction mediated by autoantibodies. The safety of antiplatelet therapy and PCI in patients who have ACS and ITP is unknown. The aim of the present study is to discuss the management strategies for patients who have ACS and ITP and to review limited data available in the literature. CASE PRESENTATION We report the case of a patient with ITP who underwent three separate coronary interventions. The first PCI with stenting was performed in the left anterior descending artery 5 years ago while the patient suffered an anterior acute myocardial infarction, and the platelet count at admission was 90 × 10(9)/L. The patient presented with recurrent ACS and severe in-stent restenosis 5 years after the first PCI, and the platelet count at admission was 18 × 10(9)/L, and elevated to 87 × 10(9)/L after platelets transfusion. He was treated successfully with cutting balloon angioplasty under anticoagulation with unfractionated heparin and antiagregation with acetylsalicylic acid and clopidogrel. Four months later after cutting balloon angioplasty, the patient received an intracoronary stent when he once again presented with recurrent ACS in the setting of restenosis. The patient has been observed for 1.5 years without restenosis after the third PCI. CONCLUSION We reviewed all the cases in the literature involving PCI and discussed the management strategies in patients with ITP and ACS. Available data suggest that PCI can be safe and feasible, and the risk-benefit equation of PCI procedures and antiplatelet therapies should be carefully evaluated, and the treatment should be individualized.
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Affiliation(s)
- Ge Li-Sha
- Department of Pediatric, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
| | - Chen Peng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, China.
| | - Li Yue-Chun
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, 109 Xueyuan Road, Wenzhou, Zhejiang, China.
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Eisen A, Bental T, Assali A, Kornowski R, Lev EI. Mean platelet volume as a predictor for long-term outcome after percutaneous coronary intervention. J Thromb Thrombolysis 2014; 36:469-74. [PMID: 23345043 DOI: 10.1007/s11239-013-0876-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Mean platelet volume (MPV) is a value that is available from standard blood count. Increased MPV is associated with increased platelet reactivity and it has been correlated with adverse cardiac outcomes in patients with acute coronary syndromes (ACS). However, there is limited information about the prognostic value of baseline MPV in a large heterogenous patient population which undergoes percutaneous coronary intervention (PCI). To examine whether baseline MPV is predictive of clinical outcomes in patients who undergo PCI. Included were consecutive patients who underwent PCI during 2004-2010 (n = 7,585, mean age 67.7 ± 12.1 years, 76.0% males) with a median follow-up period of 4 years. Baseline MPV before angiography and long-term clinical outcomes were assessed. The mean MPV was higher in women as compared to men (8.6 ± 1.2 vs. 8.5 ± 1.1 fL, p = 0.02), in diabetic versus non-diabetic patients (8.6 ± 1.2 vs. 8.4 ± 1.1 fL, p < 0.001) and in patients who were admitted with ACS (n = 4,961) compared to patients who underwent an elective PCI (8.6 ± 1.1 vs. 8.5 ± 1.1 fL, p = 0.001). On multivariate analysis, MPV was associated with mortality (HR 1.18, 95% CI 1.12-1.23, p < 0.001) and with a composite end-point of death, MI and target vessel revascularization (HR 1.09, 95% CI 1.04-1.13, p < 0.001). Baseline MPV was associated with mortality in patients undergoing an elective PCI as well as in urgent PCI (HR 1.30, 95% CI 1.20-1.40, p < 0.001 and HR 1.13, 95% CI 1.07-1.20, p < 0.001, respectively). In patients undergoing either an elective or urgent PCI, an elevated MPV is a significant predictor of cardiovascular adverse events including death.
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Affiliation(s)
- Alon Eisen
- Cardiology Department, Rabin Medical Center, 39 Jabotinsky St., 49100, Petah Tikva, Israel,
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Niu X, Yang C, Zhang Y, Zhang H, Yao Y. Mean platelet volume on admission improves risk prediction in patients with acute coronary syndromes. Angiology 2014; 66:456-63. [PMID: 24848783 DOI: 10.1177/0003319714536024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our aim was to evaluate the incremental predictive value of adding mean platelet volume (MPV) to the Global Registry of Acute Coronary Events (GRACE) risk score. The MPV and GRACE score were determined on admission in 509 consecutive patients with acute coronary syndrome (ACS). Six-month mortality or nonfatal myocardial infarction (MI) was the study end point. Overall, 61 (12%) patients reached the combined end point. Cox multivariate analysis showed that an elevated MPV was an independent predictor of 6-month mortality or MI in patients with ACS. The addition of MPV to the GRACE model improved its global fit and discriminatory capacity. The new model including MPV allowed adequate reclassification of 16% of the patients. In conclusion, the inclusion of MPV into the GRACE risk score could allow improved risk classification, thereby refining risk stratification of patients with ACS.
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Affiliation(s)
- Xiaowei Niu
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Cuiling Yang
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yiming Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Hengliang Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Yali Yao
- Department of Cardiology, the First Hospital of Lanzhou University, Lanzhou, Gansu, China
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Varol E, Uysal BA, Dogan A, Ozaydin M, Erdogan D. Mean platelet volume has a prognostic value in patients with coronary artery ectasia. Clin Appl Thromb Hemost 2011; 18:387-92. [PMID: 22146577 DOI: 10.1177/1076029611427441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to investigate the prognostic role of mean platelet volume (MPV) in patients with coronary artery ectasia (CAE). The baseline MPV values of 258 patients with CAE were screened. The mean time of follow-up was 49 ± 21 months for major adverse cardiac events (MACEs) defined as the combination of cardiac death, nonfatal myocardial infarction (MI), rehospitalization due to cardiac disorders, and readmission due to chest pain. During follow-up period, 63 (24%) MACEs developed. There were 4 (2%) cardiovascular deaths, 0 nonfatal MI, 14 (5%) rehospitalization, and 45 (17%) readmission. Mean platelet volume values were significantly higher in patients with CAE with MACEs than in patients with CAE without MACEs (9.5 ± 1.2 fL vs 8.9 ± 1.1 fL, respectively, P = .002). The rate of MACE was higher in CAE patients with MPV of >9 fL than those with MVP of ≤9 fL (33% vs. 15%, P = .001). Mean platelet volume has a prognostic value for MACEs in patients with CAE.
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Affiliation(s)
- Ercan Varol
- Department of Cardiology, Suleyman Demirel University, Isparta, Turkey.
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Yarlioglues M, Ardic I, Dogdu O, Akpek M, Zencir C, Kasapkara HA, Kelesoglu S, Elcik D, Ozdogru I, Oguzhan A, Kaya MG. The Acute Effects of Passive Smoking on Mean Platelet Volume in Healthy Volunteers. Angiology 2011; 63:353-7. [DOI: 10.1177/0003319711420131] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Idris Ardic
- Department of Cardiology, Av. Cengiz Gökçek Gaziantep Devlet Hastanesi, Gaziantep, Turkey
| | - Orhan Dogdu
- Department of Cardiology, Yozgat State Hospital, Yozgat, Turkey
| | - Mahmut Akpek
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Cemil Zencir
- Department of Cardiology, Kahramanmaras State Hospital, Kahramanmaras, Turkey
| | - Haci Ahmet Kasapkara
- Department of Cardiology, Ankara Ataturk Training and Research Hospital, Ankara, Turkey
| | - Saban Kelesoglu
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Deniz Elcik
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Ibrahim Ozdogru
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Abdurrahman Oguzhan
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
| | - Mehmet Gungor Kaya
- Department of Cardiology, School of Medicine, Erciyes University, Kayseri, Turkey
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López-Cuenca AA, Tello-Montoliu A, Roldán V, Pérez-Berbel P, Valdés M, Marín F. Prognostic Value of Mean Platelet Volume in Patients With Non-ST-Elevation Acute Coronary Syndrome. Angiology 2011; 63:241-4. [DOI: 10.1177/0003319711413892] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study is to determine mean platelet volume (MPV) in a population with non-ST-elevation acute coronary syndrome (nSTEACS) and explore its relation with prognosis. Patients (n = 329) with a diagnosis of nSTEACS at admission were recruited, with a determination of MPV in the first 12 hours at admission. We also collected blood from 87 healthy controls. A composite end point of cardiovascular death and new ACS was assessed at 6-month follow-up. Patients with nSTEACS showed larger platelets (MPV: 11.0 [10.3-11.8] vs 9.2 [8.6-10.0] fL; P < .001.). In Cox regression analysis, MPV at admission was a significant predictor of cardiovascular adverse events in univariate analysis, hazard ratio (HR) 1.4 95% confidence interval (CI) 1.1-1.8; P = .018; but after adjustment with clinical variables, MPV lost its statistical significance. In conclusion, patients with nSTEACS present with larger platelets than healthy controls, however this parameter did not show an independent prognostic significance at 6-month follow-up.
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Affiliation(s)
| | - Antonio Tello-Montoliu
- Cardiology Department, Hospital General Universitario Alicante, Alacant, Spain
- Department of Medicine, Division of Cardiology, University of Florida College of Medicine-Jacksonville, Shands Jacksonville, Jacksonville, FL, USA
| | - Vanessa Roldán
- Hematology and Clinical Oncology Department. Hospital Universitario Morales Meseguer, University of Murcia, Murcia, Spain
| | | | - Mariano Valdés
- Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Francisco Marín
- Cardiology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
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Azab B, Torbey E, Singh J, Akerman M, Khoueiry G, Mcginn JT, Widmann WD, Lafferty J. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets 2011; 22:557-66. [DOI: 10.3109/09537104.2011.584086] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Inanc T, Kaya MG, Yarlioglues M, Ardic I, Ozdogru I, Dogan A, Kalay N, Gunturk E, Gunebakmaz O, Gul I, Topsakal R. The mean platelet volume in patients with non-dipper hypertension compared to dippers and normotensives. Blood Press 2010; 19:81-5. [PMID: 20367545 DOI: 10.3109/08037050903516284] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Increased platelet activation plays an important role in the development of atherosclerosis. Mean platelet volume (MPV) is a determinant of platelet activation. In our study, we aimed to determine whether MPV levels are elevated in non-dipper patients compared with dippers and healthy controls. In addition, we tried to find out if MPV levels are correlated with blood pressure measurements in hypertensive patients. METHODS This cross-sectional study included 56 hypertensive patients; 27 age- and sex-matched healthy volunteers were enrolled to study as a control subjects. Ambulatory blood pressure monitoring was performed for all patients. Hypertensive patients were divided into two groups: 28 dipper patients (10 male, mean age 51 +/-8 years) and 28 non-dipper patients (11 male, mean age 53+/-10 years). MPV was measured in a blood sample collected in EDTA tubes and was also used for whole blood counts in all patients. RESULTS In non-dipper patients, 24-h systolic blood pressure (141.5+/-10.21 vs 132.3+/-7.7 mmHg, p<0.001), 24-h diastolic blood pressure (88.2+/-8.5 vs 81.0+/-8.2 mmHg, p<0.01) and 24-h average blood pressure (105.7+/-8.5 vs 97.7+/-7.4 mmHg, p<0.001) are significantly higher than dippers. Whereas daytime measurements were similar between dippers and non-dippers, there was a significant difference between each group during night-time measurements (night-time systolic 137.1 +/-11.0 vs 120.2+/-8.0 mmHg, p<0.001; night-time diastolic 85.3+/-8.0 vs 72.8+/-7.9 mmHg, p<0.001). Non-dipper patients (9.61 +/-0.42 fl) demonstrated higher levels of MPV compared with dippers (9.24+/-0.35 fl) and normotensives (8.87+/-0.33 fl) (p<0.001 and p<0.001, respectively). There was significant correlation between MPV and ambulatory diastolic and systolic blood pressure in non-dipper hypertensives. CONCLUSION Our results suggest that MPV, a determinant of platelet activation, has a positively correlation with blood pressure and elevated in non-dipper compared with dippers and controls. Increased platelet activation could contribute to increase the atherosclerotic risk in non-dipper patients compared with dippers.
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Affiliation(s)
- Tugrul Inanc
- Erciyes University, Department of Cardiology, Kayseri, Turkey.
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Galiuto L, Paraggio L, Liuzzo G, de Caterina AR, Crea F. Predicting the no-reflow phenomenon following successful percutaneous coronary intervention. Biomark Med 2010; 4:403-20. [DOI: 10.2217/bmm.10.55] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
In the setting of acute myocardial infarction, early and adequate reopening of an infarct-related artery is not necessarily followed by a complete restoration of myocardial perfusion. This condition is usually defined as ‘no-reflow’. The pathophysiology of no-reflow is multifactorial since extravascular compression, microvascular vasoconstriction, embolization during percutaneous coronary intervention, and platelet and neutrophil aggregates are involved. In the clinical arena, angiographic findings and easily available clinical parameters can predict the risk of no-reflow. More recently, several studies have demonstrated that biomarkers, especially those related to the pathogenetic components of no-reflow, could also have a prognostic role in the prediction and in the full understanding of the multiple mechanisms of this phenomenon. Thus, in this article, we investigate the role of several biomarkers on admission in predicting the occurrence of no-reflow following successful percutaneous coronary intervention.
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Affiliation(s)
| | - L Paraggio
- Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A Gemelli, Largo A Gemelli, 8, 00168 Rome, Italy
| | - G Liuzzo
- Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A Gemelli, Largo A Gemelli, 8, 00168 Rome, Italy
| | - AR de Caterina
- Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A Gemelli, Largo A Gemelli, 8, 00168 Rome, Italy
| | - F Crea
- Institute of Cardiology, Catholic University of the Sacred Heart, Policlinico A Gemelli, Largo A Gemelli, 8, 00168 Rome, Italy
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Bath P, Algert C, Chapman N, Neal B. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004; 35:622-6. [PMID: 14976328 DOI: 10.1161/01.str.0000116105.26237.ec] [Citation(s) in RCA: 232] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Mean platelet volume (MPV) is positively associated with measures of platelet activity and may be a useful indicator of the risk of vascular events in a variety of patient groups. METHODS The association of MPV with the risk of stroke was assessed in the Perindopril Protection Against Recurrent Stroke Study (PROGRESS). All participants had a history of cerebrovascular disease at baseline, and analyses were adjusted for the effects of potential confounders. RESULTS The study followed 3134 individuals for an average of 3.9 years (mean age, 65 years; 71% male; average MPV, 10.0 fL). Three hundred eighty-three individuals had 402 stroke events, and 160 had major coronary events. MPV was positively associated with the risk of stroke, with an 11% increased relative risk (95% CI, 3% to 19%) of stroke per femtoliter greater MPV. There was no clear association of MPV with the risk of major coronary events (9% decreased relative risk; 95% CI, -23% to 7%). Perindopril did not alter MPV. CONCLUSIONS MPV is an independent predictor of the risk of stroke among individuals with a history of stroke or transient ischemic attack. The measurement of MPV may add useful prognostic information for clinicians managing patients with a history of cerebrovascular disease.
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Affiliation(s)
- Philip Bath
- Division of Stroke Medicine, Institute of Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UK.
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