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Mean platelet volume variability in young patients with non-ST elevation acute myocardial infarction
A M Andronescu1, C Delcea2, V Enache1
1Internal Medicine and Cardiology Department, "Sf. Pantelimon" Emergency Hospital, Bucharest, Romania ; "C. Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Insights
Mean platelet volume (MPV) is elevated in young patients with non-ST elevation myocardial infarction (NSTEMI) and predicts the condition independently of cardiovascular risk factors. This finding highlights MPV
Area of Science:
- Cardiology
- Hematology
- Internal Medicine
Background:
- Platelet activation is crucial in the pathophysiology of non-ST elevation acute coronary syndromes (NSTEMI).
- Mean platelet volume (MPV), a marker of platelet reactivity, has been linked to increased risk of acute coronary events.
Purpose of the Study:
- To investigate mean platelet volume (MPV) variability in young patients diagnosed with NSTEMI.
- To compare MPV in young NSTEMI patients with young individuals having cardiovascular risk factors but no ischemic heart disease, and with elderly NSTEMI patients.
Main Methods:
- Analysis of data from 174 cardiology patients admitted between January 2009 and December 2010.
- Study groups included: 35 young patients (<45 years) with NSTEMI, 41 young patients (<45 years) without ACS, and 98 older patients (>45 years) with NSTEMI.
Main Results:
- Young NSTEMI patients exhibited significantly higher MPV (8.88 ± 1.14fL) compared to young controls (8.31 ± 0.37fL, p<0.01).
- Elderly NSTEMI patients showed the highest MPV (9.48 ± 1.35fL, p=0.02), with MPV correlating positively with age (r=0.375, p<0.0001).
- Multivariate analysis identified elevated MPV as an independent predictor of NSTEMI in young patients (OR 2.75, p=0.04), while traditional risk factors were not significant predictors.
Conclusions:
- Non-ST elevation myocardial infarction (NSTEMI) is associated with elevated mean platelet volume (MPV) in both young and elderly patients.
- Elevated MPV independently predicts NSTEMI in young individuals, irrespective of their cardiovascular risk profile.
Introduction:
Platelet activation plays an important role in the pathophysiology of non-ST elevation acute coronary syndromes (ACS). Mean platelet volume (MPV), an indicator of platelet reactivity, was previously associated with an increased risk of acute coronary events.
Objective:
To investigate the MPV variability in young patients presenting with NSTEMI, as compared to young patients with cardiovascular risk factors and no overt ischemic cardiac disease, as well as with elderly patients presenting with NSTEMI.
Methods:
We analyzed data from 174 patients admitted in our cardiology department between January 2009 and December 2010: 35 patients younger than 45 years of age with NSTEMI, 41 patients younger than 45 without ACS and 98 patients older than 45 with NSTEMI.
Results:
Young patients with NSTEMI had a significantly higher mean MPV (8.88 ± 1.14fl) than young patients without ACS (8.31 ± 0.37fl, p<0.01), while the older subjects with NSTEMI had the highest mean MPV (9.48 ± 1.35fl, p=0.02). MPV correlated with age (r=0.375, p<0.0001). After a multivariate analysis, elevated levels of MPV were independent predictors of NSTEMI in young patients (odds ratio [OR] 2.75, 95% CI 1.04-7.92, p=0.04), while hypertension (OR 0.34, 95% CI 0.6-1.78, p=0.20), dyslipidemia (OR 1.61, 95% CI 0.17-14.51, p=0.67), obesity (OR 5.77, 95% CI 0.80-41.53, p=0.08) and smoking status (OR 8.97, 95% CI 0.84-95.26, p=0.06) were not.
Conclusion:
NSTEMI is associated with high MPV in old as well as in young patients. Elevated MPV is predictive for NSTEMI in young patients, separately of a high cardiovascular risk profile.
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