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Dindas F, Koyun E, Turkyilmaz E, Abacioglu OO, Yildirim A, Sahin A, Dindar B, Dogdus M, Candan O. Systemic Immune Inflammation Index is a Novel Marker in Predicting the Presence and Severity of Isolated Coronary Artery Ectasia. Arq Bras Cardiol 2023; 120:e20220056. [PMID: 36629598 PMCID: PMC9833212 DOI: 10.36660/abc.20220056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 06/26/2022] [Accepted: 09/01/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The underlying pathology of isolated coronary artery ectasia (CE) has not been fully elucidated. OBJECTIVE We aimed to examine the relationship between the systemic immune inflammation index (Sıı), which corresponds to the multiplying of the neutrophil-to-lymphocyte ratio (NLR) and the platelet counts, and isolated CE. METHOD The retrospective study population included 200 patients with isolated CE, 200 consecutive with obstructive coronary artery disease, and 200 consecutive with a normal coronary artery angiogram. A 2-sided p-value of <0.05 was considered significant. RESULTS Sıı, NLR, platelet-to-lymphocyte ratio (PLR), and monocyte-to-high density lipoprotein cholesterol ratio (MHR) were significantly higher in the CE group compared with the other groups (all p<0.001). In multivariate analysis, Sıı (p<0.001, OR = 1.005, 95% CI =1.004-1.005) was found to be an independent predictor of isolated CE. In Receiver Operating Characteristic curve analysis, Sıı had a higher Area Under the Curve than NLR, PLR, and MHR. Sıı value of >517.35 has 79% sensitivity, 76% specificity for the prediction of the CE [AUC: 0.832, (p<0.001)]. Sıı had a significant correlation with the number of ectatic coronary arteries and Markis classification (r:0.214 p=0.002; r:-0.195, p=0.006, respectively). CONCLUSION To the best of our knowledge, this is the first study that Sıı was significantly associated with isolated CE presence and anatomical severity.
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Affiliation(s)
- Ferhat Dindas
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Emin Koyun
- Sivas Cumhuriyet UniversityDepartment of CardiologySivasTurquia Sivas Cumhuriyet University , Department of Cardiology , Sivas – Turquia
| | - Erdem Turkyilmaz
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Ozge Ozcan Abacioglu
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Arafat Yildirim
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Anil Sahin
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Baris Dindar
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
| | - Mustafa Dogdus
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
- University of Health SciencesAdana Health Practice and Research CenterAdanaTurquia University of Health Sciences , Adana Health Practice and Research Center , Adana – Turquia
| | - Ozkan Candan
- Usak UniversityTraining and Research HospitalDepartment of CardiologyUsakTurquia Usak University , Training and Research Hospital , Department of Cardiology , Usak – Turquia
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Ben Abderrahim S, Gharbaoui M, Zaara MA, Rammeh-Rommani S, Hamdoun M, Ben Khelil M. Fatal coronary ectasia: An autopsy case report and review of literature. J Forensic Leg Med 2021; 79:102132. [PMID: 33667793 DOI: 10.1016/j.jflm.2021.102132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/02/2021] [Accepted: 02/14/2021] [Indexed: 11/29/2022]
Abstract
Coronary ectasia is a rare vessel defect that represents a pathological and incidental finding in routine coronary angiography performed for other coronary syndromes. This defect exposes to the risk of intra-coronary thrombosis by blood stasis due to the turbulent blood flow in those dilated areas that can lead to sudden death. We report an autopsy case of a male subject suddenly deceased. A medico-legal autopsy concluded an ischemic heart failure due to a vascular thrombosis by a blood clot in a coronary ectasia. Our case report aimed to discuss the mechanisms of sudden death attributed to coronary artery ectasia.
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Affiliation(s)
- Sarra Ben Abderrahim
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Meriem Gharbaoui
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mohamed Amine Zaara
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Soumaya Rammeh-Rommani
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Pathological Anatomy and Cytology, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Moncef Hamdoun
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia
| | - Mehdi Ben Khelil
- Tunis Faculty of Medicine, University of Tunis El Manar, Djebel Lakhdhar Street, La Rabta, 1007, Tunis, Tunisia; Department of Forensic Medicine, Charles Nicolle University Hospital, 138, Boulevard 9 Avril 1938, 1006, Tunis, Tunisia.
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Dereli S, Çerik İB, Kaya A, Bektaş O. Assessment of the Relationship Between C-Reactive Protein-to-Albumin Ratio and the Presence and Severity of Isolated Coronary Artery Ectasia. Angiology 2020; 71:840-846. [PMID: 32519552 DOI: 10.1177/0003319720930983] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
We investigated the relationship between C-reactive protein-to-albumin ratio (CAR) and coronary artery ectasia (CAE). The retrospective study population included 150 patients with isolated CAE, 150 with obstructive coronary artery disease (CAD), and 150 with a normal coronary artery angiogram (NCA). The severity of isolated CAE was determined according to the Markis classification. C-reactive protein-to-albumin ratio was significantly higher in patients with isolated CAE than in those with obstructive CAD and NCA (10.5 [5.9-30.9], 5.7 [1.8-13.2] and 3.0 [0.9-8.9], respectively). Logistic regression analysis showed that CAR (odds ratio [OR]: 3.054, 95% CI: 1.021-9.165, P = .001), platelet-to-lymphocyte ratio (PLR; OR: 1.330, 95% CI: 1.025-1.694, P = .044), and monocyte-to-high density cholesterol ratio (MHR; OR: 1.031, 95% CI: 1.009-1.054, P = .006) were independently associated with the presence of isolated CAE. Receiver operating characteristic curve analysis showed that CAR (area under the curve [AUC] ± standard error [SE] = 0.838 ± 0.016; P < .001) had a stronger diagnostic value for detecting significant CAE than PLR (AUC ± SE = 0.632 ± 0.023) and MHR (AUC ± SE = 0.726 ± 0.022). C-reactive protein-to-albumin ratio had a significantly strong correlation with the severity of isolated CAE (r = 0.536, P < .001). To the best of our knowledge, this study showed for the first time that CAR was significantly associated with CAE presence and severity.
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Affiliation(s)
- Seçkin Dereli
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - İdris Buğra Çerik
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Ahmet Kaya
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
| | - Osman Bektaş
- Department of Cardiology, 472606Ordu University Faculty of Medicine, Turkey
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Wang J, Li X, Pu J, Jin S, Jia L, Li X, Liu F, Yang Y. Mean platelet volume and coronary plaque vulnerability: an optical coherence tomography study in patients with non-ST-elevation acute coronary syndrome. BMC Cardiovasc Disord 2019; 19:128. [PMID: 31142268 PMCID: PMC6542039 DOI: 10.1186/s12872-019-1115-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 05/21/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND 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). METHODS 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. RESULTS 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). CONCLUSIONS Higher MPV is independently associated with higher risk of plaque rupture as evidenced by OCT in our cohort of NSTE-ACS patients.
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Affiliation(s)
- Jun Wang
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xing Li
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Jun Pu
- The Renji Hospital of Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Siyu Jin
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Lu Jia
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Xiaomei Li
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Fen Liu
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China
| | - Yining Yang
- Department of Coronary Heart Disease, the First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830011, China.
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Liang S, Zhang Y, Gao X, Zhao H, Di B, Sheng Q, Liu R. Is Coronary Artery Ectasia a Thrombotic Disease? Angiology 2018; 70:62-68. [PMID: 29929375 DOI: 10.1177/0003319718782807] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Coronary artery ectasia (CAE) is a rare disease and a substantial portion of patients with CAE are first diagnosed with acute myocardial infarction (AMI). The question was raised if CAE was a kind of thrombotic disease. We assessed a consecutive series of 119 patients with CAE including 32 patients with AMI (CAE + AMI group) and 87 patients without AMI (CAE group). During the same period, 90 patients with coronary heart disease, 90 patients with normal coronary arteries (control), and 120 AMI patients without CAE (AMI group) were randomly selected and evaluated. Both current and previous AMI prevalence rates in the CAE population were higher than the AMI rate for the other patients undergoing coronary angiograms; the mean platelet volume and fibrinogen were increased in the CAE + AMI and CAE groups. For patients with CAE with AMI, most of the thrombotic lesions were in the ectasia site. After dividing the patients with CAE into with and without antiplatelet treatment groups before admission, the AMI rate was lower in the antiplatelet group. Platelets may participate in the thrombotic process in CAE. Antiplatelet treatment may decrease the AMI rate of patients with CAE.
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Affiliation(s)
- Siwen Liang
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yue Zhang
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xiangyu Gao
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Huiqiang Zhao
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Beibing Di
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qianqian Sheng
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Ruifeng Liu
- 1 Department of Cardiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Gök M, Kundi H, Kiziltunç E, Topçuoğlu C, Örnek E. The relationship between serum endocan levels and the presence/severity of isolated coronary artery ectasia. Cardiovasc Endocrinol Metab 2018; 7:42-46. [PMID: 31646279 DOI: 10.1097/xce.0000000000000143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/22/2017] [Indexed: 11/25/2022]
Abstract
Objective The aim of this study was to investigate the relationship between serum endocan levels and the presence and severity of isolated coronary artery ectasia (CAE). Patients and methods A total of 52 patients with CAE without obstructive coronary artery disease and 33 participants with a normal coronary artery were included in this study. The severity of CAE was graded according to Markis classification. Serum endocan levels were measured by enzyme-linked immunosorbent assay method. Results In multivariate regression analysis, high sensitivity C-reactive protein and endocan levels were found to be significantly associated with the presence of isolated CAE. However, there was no relationship between serum endocan levels and the severity of CAE according to Markis classification. Conclusion Plasma endocan levels may reflect the presence of isolated CAE, suggesting that endocan may be involved in the pathogenesis of isolated CAE.
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Affiliation(s)
| | | | | | - Canan Topçuoğlu
- Biochemistry, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Ozturk S, Yetkin E, Waltenberger J. Molecular and cellular insights into the pathogenesis of coronary artery ectasia. Cardiovasc Pathol 2018; 35:37-47. [PMID: 29772448 DOI: 10.1016/j.carpath.2018.04.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/17/2018] [Accepted: 04/12/2018] [Indexed: 01/17/2023] Open
Abstract
Coronary artery ectasia describes a local or diffuse dilatation of the epicardial coronary arteries. This review summarizes the molecular and cellular mechanisms involved in the pathogenesis of coronary artery ectasia. Better identification of the pathophysiologic steps will shed light into the clinical significance and may have direct implications for the management strategies of this disease. Additionally, understanding the underlying etiology may help to improve treatment modalities specific to coronary artery ectasia.
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Affiliation(s)
- Selcuk Ozturk
- Ankara Education and Research Hospital, Department of Cardiology, Ankara 06230, Turkey.
| | - Ertan Yetkin
- Private Yenisehir Hospital, Department of Cardiology, Mersin, Turkey
| | - Johannes Waltenberger
- University of Münster, Faculty of Medicine, Münster, Germany; Cells-in-Motion Cluster of Excellence (EXC 1003-CiM), University of Münster, Münster, Germany
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Wang Y, Wang Y, You S, Wang H, Yin D, Dou K, Song W. Independent Prognostic Value of High-sensitivity C-reactive Protein in Patients with Coronary Artery Ectasia. Chin Med J (Engl) 2017; 129:2582-2588. [PMID: 27779165 PMCID: PMC5125337 DOI: 10.4103/0366-6999.192778] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Despite its severity, coronary artery ectasia (CAE) is still poorly understood. High-sensitivity C-reactive protein (hs-CRP) has been recognized as a prognostic factor in some cardiovascular diseases but not assessed in CAE. The aim of this observational study was to investigate the prognostic value of hs-CRP in CAE. METHODS Our analysis evaluated the effect of the baseline hs-CRP on cardiovascular events (CVs) (cardiac death and nonfetal myocardial infarction) in consecutively enrolled stable CAE patients. We used the Cox proportional hazards regression models to examine the association between baseline hs-CRP level and follow-up CVs in CAE. The net reclassification improvement and integrated discrimination improvement (IDI) of hs-CRP were also assessed. RESULTS We obtained the follow-up results of 540 patients over a median follow-up period of 36 (37.41 ± 15.88) months. The multivariable Cox analysis showed that the hs-CRP was a significant predictor of adverse outcomes in CAE (hazard ratio [HR]: 2.99, 95% confidence interval [CI]: 1.31-6.81, P = 0.0091). In Kaplan-Meier analysis, the group with hs-CRP >3 mg/L had a lower cumulative 66-month event-free survival rate (log-rank test for trend, P = 0.0235) and a higher risk of CVs (HR = 2.66, 95% CI: 1.22-5.77, P = 0.0140) than the group with hs-CRP ≤3 mg/L. Hs-CRP added predictive information beyond that given by the baseline model comprising the classical risk factors (P value for IDI = 0.0330). CONCLUSIONS A higher level of hs-CRP was independently associated with cardiac death and nonfatal myocardial infarction in CAE patients. The hs-CRP level may therefore provide prognostic information for the risk stratification of CAE patients.
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Affiliation(s)
- Yintang Wang
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Yang Wang
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Shijie You
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Hongjian Wang
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Dong Yin
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Kefei Dou
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
| | - Weihua Song
- Department of Cardiology, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Fuwai Hospital, Beijing 100037, China
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Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P, Thakkinstian A. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost 2015; 114:1299-309. [PMID: 26245769 DOI: 10.1160/th15-04-0280] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/17/2015] [Indexed: 12/22/2022]
Abstract
Large platelets with high haemostatic activity may lead to increased platelet aggregation.. Mean platelet volume (MPV), an indicator of platelet reactivity, may emerge as a prognostic marker in patients with coronary artery disease (CAD). It was the objective of this study to conduct a systematic review and meta-analysis to assess prognostic effects of MPV on cardiovascular events (CVE) in CAD patients. We searched MEDLINE and SCOPUS from inception to January 2, 2014. All studies that reported MPV and the incidence of cardiovascular events in CAD patients were included. Two reviewers independently extracted the data. A random-effects model was applied for pooling the mean difference of MPV between patients with vs without CVE. Among 30 eligible studies, eight studies reported mean difference of MPV between CVE groups, 11 studies reported MPV dichotomous into high vs low MPV groups, and 11 studies reported both. The pooled mean difference was 0.69 fL (95 %CI = 0.36, 1.01), i. e. patients with CVE had a MPV about 0.69 fL higher than non-CVE. Patients with higher MPV were about 12 % more likely to die than patients with lower MPV (RR 1.12; 95 %CI = 1.02-1.24). However, pooling these effects was based on high heterogeneity and the source of heterogeneity could not be identified. This might be explained by many differences among included studies (e. g. study population, outcomes of interest, analysate, time between blood collection and MPV analysis, etc). These findings suggest that MPV may be a useful prognostic marker in patients with CAD.
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Affiliation(s)
| | - Pawin Numthavaj
- Pawin Numthavaj, MD, Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 370 Rama VI road, Rajathevi, 10400 Bangkok, Thailand, Tel.: 6622011284, Fax: 6622011284, E-mail:
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