No abstract

We investigated 2 hypotheses: (1) a relationship between platelet indices and stable coronary artery disease (CAD) and acute ST-segment elevation myocardial infarction (STEMI) and (2) a relationship between platelet indices on admission and thrombolysis outcomes in patients with STEMI. A total of 260 patients were enrolled. The white blood cell (WBC) and platelet distribution width (PDW) were found to be increased in patients with STEMI (P for both < .001). White blood cell and PDW were independent predictors of acute STEMI. Mean platelet volume (MPV) and PDW were significantly higher in the thrombolysis failure group than in the thrombolysis success group (9.9 ± 1.8 vs 9.2 ± 1.5 fL, P = .021 and 17.7 ± 1.0 vs 16.4 ± 2.1 fL, P < .001, respectively). Mean platelet volume and PDW were independent predictors of thrombolysis failure. Patients with acute STEMI had higher PDW than did patients with stable CAD. In addition, higher PDW and MPV seem to correlate with thrombolysis failure in patients with STEMI.

Aims. The aim of this study was to investigate the relationship of echocardiographic epicardial fat thickness (EFT) with carotid intima-media thickness (CIMT), in patients with type 2 diabetes mellitus (T2DM). Methods and Results. A total of 139 patients with T2DM (mean age 54.3 ± 9.2 and 49.6% male) and 40 age and sex-matched control subjects were evaluated. Echocardiographic EFT and ultrasonographic CIMT were measured in all subjects. Patients with T2DM had significantly increased EFT and CIMT than those of the controls (6.0 ± 1.5 mm versus 4.42 ± 1.0 mm, P < 0.001 and 0.76 ± 0.17 mm versus 0.57 ± 0.14 mm, P < 0.001, resp.). EFT was correlated with CIMT, waist circumference, BMI, age, duration of T2DM, HbA1c in the type 2 diabetic patients. Linear regression analysis showed that CIMT (β = 3.52, t = 3.72, P < 0.001) and waist circumference (β = 0.36, t = 2.26, P = 0.03) were found to be independent predictors of EFT. A cutoff high risk EFT value of 6.3 mm showed a sensitivity and specificity of 72.5% and 71.7%, respectively, for the prediction of subclinical atherosclerosis. Conclusion. We found that echocardiographic EFT was significantly higher in patients with T2DM. Our study also showed that EFT was strongly correlated with waist circumference and CIMT as being independent of sex.

Preprocedural high-thrombus burden (HTB) of infarct-related artery (IRA) is a harbinger of procedural complications following primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). The HTB of IRA can lead to poor outcomes by various mechanisms, including no-reflow phenomenon, increased myocardial necrosis and with subsequent reduced survival benefit at follow-up. In this study, we investigated the relationship between all platelet indices on admission and thrombus burden and the no-reflow phenomenon after primary PCI of IRA in patients with STEMI. We retrospectively enrolled 475 patients with STEMI undergoing primary PCI. Study population was divided into two groups according to the thrombolysis in myocardial infarction thrombus grade of IRA as low-thrombus burden or HTB. There were no statistically significant differences in platelet indices, including platelet count, platelet-large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution with (PDW) among the groups. However, in the subgroup analysis, P-LCR, MPV and PDW were significantly higher in the no-reflow patients than reflow patients despite similar platelet count (P for all < 0.001). The cutoff value of P-LCR for predicting no-reflow was 26.5% with a sensitivity of 67.0% and a specificity of 62% (area under the curve, 0.689; 95% confidence interval, 0.614-0.765; P < 0.001). Furthermore, P-LCR, MPV and PDW had similar AUC (0.689, P < 0.001; 0.688, P < 0.001; and 0.677, P < 0.001; respectively) for predicting no-reflow phenomenon after primary PCI. As a result, all of the platelet indices have no effect on thrombus load of IRA, however, these parameters seem to impair epicardial perfusion after primary PCI.

No abstract

Platelets and clotting cascade play a major role in development of atrial thrombus in patients with atrial fibrillation. The mean platelet volume (MPV) reflects platelet size and is considered a marker and determinant of platelet function because larger platelets are hemostatically more reactive than platelets of normal size, increasing the propensity to thrombosis. We have investigated the relationship between MPV and left atrial thrombus in patients with persistent atrial fibrillation. A total of 205 consecutive patients (men: 67.3%, women: 32.7%; mean age: 62.3 ± 12.8) who had persistent atrial fibrillation, undergone transesophageal and transthoracic echocardiography. Study individuals were divided into two groups. Group 1 (n: 96, 46.8%): atrial fibrillation complicated with atrial thrombus and group 2 (n: 109, 53.2%): atrial fibrillation free of thrombus, which was identified by means of transesophageal echocardiogram. The MPV, platelet distribution weight, and platelet count were measured. There was no difference in terms of MPV, platelet distribution weight, and platelet count in two groups. MPV was not correlated with thrombus and spontaneous echo contrast. Left atrial thrombus was included in multivariate logistic regression analysis and only low ejection fraction was a predictor of left atrial thrombus (P = 0.04). This is first report showing that MPV is not related with left atrial thrombus in patients with atrial fibrillation. According to our result, MPV cannot be considered as an index of left atrial thrombus in patients with atrial fibrillation.

N/L ratio can be used to predict poor FC in patients with CHF.

In patients with CTO, a poor coronary collateral status and multivessel disease may further impair electrical homogeneity. Our results indicate that successful CTO PCI reduces the arrhythmic vulnerability of the myocardium on the basis of an analysis of the TpTe, the TpTe/QT ratio, and QTc dispersion.