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Published on: January 28, 2020
Can mean platelet component be used as an index of platelet activity in stable coronary artery disease?
John Cooke1, Tracy Murphy, Eugene McFadden
1Mid-Western Regional Hospital, Dooradoyle, Limerick, Ireland.
Insights
Mean platelet component (MPC) does not indicate platelet activation in stable coronary artery disease (CAD). This routine blood test measure is not useful for differentiating CAD patients from controls in clinical practice.
Area of Science:
- Cardiology
- Hematology
- Clinical Pathology
Background:
- Platelet activation is central to acute coronary syndromes and vascular disease.
- Current platelet activation markers lack routine clinical applicability.
- Mean Platelet Component (MPC) is a novel measure of platelet density from routine blood counts.
Purpose of the Study:
- To assess if MPC is elevated in stable coronary artery disease (CAD).
- To evaluate MPC's utility in distinguishing stable CAD patients from controls.
- To determine MPC's role in everyday clinical practice for CAD assessment.
Main Methods:
- Prospective study of 345 patients undergoing elective coronary angiography.
- Full blood count and MPC measurement using an ADVIA-120 analyser.
- Analysis of 324 patients, with 253 diagnosed with CAD.
Main Results:
- No significant difference in MPC between patients with CAD and controls (p=0.467).
- No correlation found between MPC and CAD severity (Kendall's tau b=-0.086, p=0.04).
- CAD patients were significantly older than controls (63.8 vs 56.0 years, p<0.001).
Conclusions:
- MPC is not a reliable indicator of platelet activity in stable CAD.
- MPC measurement is not clinically useful for differentiating stable CAD patients.
- Current routine blood count parameters do not reflect platelet activation in stable CAD.
Abstract:
Acute coronary syndrome is associated with intracoronary thrombosis secondary to platelet activation. Previous groups have investigated platelet activation in both stable and unstable vascular disease. Most measures of platelet activation are not routinely available or easily adaptable to large scale clinical use. Recently, measurement of the mean platelet component (MPC) has become part of the routine data provided by an automated full blood count analyser, the Advia 120. MPC measures platelet density which changes on platelet activation. Our objectives were to determine if platelet activation, as measured by MPC, is increased in patients with stable coronary artery disease (CAD) and to determine if MPC could be useful in differentiating people with stable CAD from controls on an everyday clinical basis. Three hundred and forty-five consecutive patients attending for elective coronary angiography had full blood count analysis and MPC measurement performed using an ADVIA-120 analyser. Three hundred and twenty-four were analysed in our final dataset. Two hundred and fifty-three (78%) had CAD. Patients with CAD were significantly (p<0.001) older than those without (63.8 versus 56.0 years). Results failed to demonstrate a difference (p=0.467) in MPC between patients with CAD and those with normal coronary arteries (25.8 versus 26.0). Likewise, there was no correlation between MPC and the severity of CAD (Kendall's tau b=-0.086, p=0.04). MPC is not a useful index of platelet activity in stable CAD when used in everyday clinical practice.
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