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Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction
Bartosz Hudzik1,2, Ilona Korzonek-Szlacheta3, Janusz Szkodziński4
1Third Department of Cardiology, Silesian Center for Heart Disease, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Katowice, Poland. bartekh@mp.pl.
Insights
In diabetic patients with acute myocardial infarction, increasing multimorbidity is linked to higher mean platelet volume (MPV). Higher MPV values correlate with more comorbidities, indicating a potential marker for increased cardiovascular risk.
Area of Science:
- Cardiology
- Diabetology
- Hematology
Background:
- Diabetes mellitus (DM) is a common condition in patients with multiple comorbidities.
- Platelet activation, indicated by mean platelet volume (MPV), is crucial in atherothrombosis, especially in acute myocardial infarction (AMI).
- Elevated MPV is associated with poor prognosis in various cardiovascular and non-cardiovascular diseases.
Purpose of the Study:
- To investigate the association between multimorbidity and MPV in diabetic patients experiencing ST-elevation myocardial infarction (STEMI).
- To explore the relationship between the number of comorbidities and MPV in this patient cohort.
Main Methods:
- A study included 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention.
- Patients were categorized into groups based on the number of comorbidities: ≤1 (Group 1) and ≥2 (Group 2).
- A subanalysis further divided the multimorbid group into those with 2-3 comorbidities (Group 2A) and those with ≥4 comorbidities (Group 2B).
Main Results:
- The prevalence of comorbidities was: 1 (15.9%), 2 (22.0%), 3 (34.3%), and ≥4 (22.7%).
- Mean platelet volume (MPV) and platelet distribution width (PDW) were significantly elevated in patients with multimorbidity compared to those with fewer comorbidities.
- A moderate positive correlation was observed between MPV and the total number of comorbidities, including both cardiovascular disease (CVD) and non-CVD conditions.
Conclusions:
- Multimorbidity is associated with increased platelet volume indices in diabetic patients with STEMI.
- MPV values demonstrate a dose-dependent relationship with the number of comorbid conditions.
- Elevated MPV may serve as a marker for increased thrombotic risk in diabetic patients with complex disease profiles.
Aims:
Diabetes mellitus (DM) is one of the most frequently detected conditions in multimorbid disease clusters. Platelet activation is one of the key mechanisms underlying atherothrombosis in acute myocardial infarction. Available data link mean platelet volume (MPV) to poor prognosis not only in cardiovascular and non-cardiovascular disease. Given the lack of research data on the association between disease clusters and MPV, we have set out to investigate the link between multimorbidity and MPV in diabetic patients with acute myocardial infarction.
Methods:
A total of 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N = 58) with ≤ 1 comorbidity and group 2 (N = 219) with ≥ 2 comorbidities. A subanalysis was performed within the multimorbidity group: group 2A with two or three comorbidities (N = 156) and group 2B with at least four comorbidities (N = 63).
Results:
In the study population, 15.9% of patients had one comorbidity, and 22.0, 34.3, and 22.7% of patients had two, three, or at least four comorbid conditions, respectively. Both MPV and PDW were elevated in multimorbid patients (9.3 vs 10.8 fl and 9.5 vs 10.3 fl, respectively). The highest platelet volume indices were observed in patients with at least four comorbid conditions. There was a moderate positive correlation between MPV and the total number of comorbidities, the number of CVD comorbidities, and the number of non-CVD comorbidities.
Conclusions:
These findings indicate that multimorbidity is associated with an increase in platelet volume indices. MPV values increased with the increasing number of comorbid conditions. Importantly, MPV values were elevated in some, but not all CVD and non-CVD conditions.
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