Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction

Abstract

Mean platelet volume (MPV) is a marker of platelet activation. An increased MPV is associated with acute myocardial infarction (AMI) and long-term mortality. The aim of this study was to compare MPV in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Also, we investigated the value of MPV on in-hospital mortality and long-term prognosis of patients with STEMI and NSTEMI. We studied 429 patients with AMI (70.4% male, 61.9 ± 12.4 years; 279 patients with STEMI, 150 patients with NSTEMI). MPV and platelet count were similar in both groups. Elevated MPV increased the risk of death by 3.1-fold (p < 0.001) in STEMI group during the hospitalization. However, increased MPV was not associated with in-hospital mortality in NSTEMI group. The area under the receiver operating characteristic curve of MPV was 0.868 (95% CI, 0.830-0.907) for predicting two-year mortality. A cut-off point of 11.1 fL showed a sensitivity of 81% and a specifity of 77% for prediction of two-year mortality. Kaplan-Meier survival curve showed two-year mortality rate of 12.5% in patients with MPV >11.1 fL versus 9.9% in patients with MPV <11.1 fL (p < 0.001). Cox regression analysis showed MPV to be an independent predictor of two-year mortality (Hazard ratio 1.7; 95% CI 1.5-1.9; p < 0.001). An increased MPV is an independent predictor of in-hospital mortality in patients with STEMI. However, elevated levels of MPV did not predict in hospital mortality in NSTEMI group. The increase in MPV values was independently correlated with two-year mortality in all study patients.

Mean platelet volume and its prognostic value in acute coronary syndrome complicated by cardiogenic shock

“…In some studies conducted in AMI, elevated MPV was associated with higher risk of death and recurrent infarction not only in hospital but also during the 2 years observation after ACS [2,[19][20][21][22]. Taglieri et al [7] investigated higher risk of primary end-point, composed of cardiovascular death and re-MI at 1 year after ACS in patients with NSTEMI with MPV ³ 8.9 fl.…”

Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention

“…It has also been recognized as an independent risk factor for MI, but not for coronary artery disease prevalence [6,7]. Measured at 6 months after acute MI, MPV has been shown to predict recurrent MI and death in 2-year follow up [8]. In ST-segment elevation MI treated with percutaneous coronary intervention (PCI), MPV has been observed to be a strong, independent factor of impaired angiographic reperfusion and 6-month mortality [9].…”

Volume Plaquetário Médio Como Preditor de Desfechos Cardiovasculares Maiores e Fluxo Coronariano Final em Pacientes Submetidos à Intervenção Coronária Percutânea Primária

“…15 In the scenario of myocardial infarction, it has been shown that the MPV measured six months after the event was able to predict recurrent infarction and mortality in 2 years. 16 In 2005, Huczek et al 17 demonstrated in 398 patients undergoing PPCI that MPV measured before the procedure was a strong independent predictor of reperfusion failure and mortality in 6 months. No-reflow phenomenon was observed in 21.2% vs. 5.5% (p = 0.0001), when comparing patients with MPV greater to or equal and lower than 10.3 fL, respectively.…”