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Mean Platelet Volume and Major Adverse Cardiac Events following Percutaneous Coronary Intervention
Younes Nozari1, Maziar Parsa1, Arash Jalali1
1Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Insights
Pre-procedural mean platelet volume (MPV) is linked to cardiovascular risk factors. High MPV was a borderline predictor for major adverse cardiac events (MACE) after elective percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Hematology
- Clinical Medicine
Background:
- Mean platelet volume (MPV) assesses platelet function and predicts cardiovascular events.
- Investigated MPV's predictive value for major adverse cardiac events (MACE) in elective percutaneous coronary intervention (PCI) candidates.
Purpose of the Study:
- To determine if pre-procedural MPV predicts MACE in patients undergoing elective PCI.
- To explore the association between MPV levels and cardiovascular risk factors.
Main Methods:
- Retrospective cohort study of 4199 elective PCI candidates (unstable angina or NSTEMI).
- MPV levels categorized into tertiles for comparison.
- MACE defined as in-hospital mortality, cardiac death, MI, TLR, or TVR.
Main Results:
- Higher MPV associated with older age, hypertension, diabetes, prior CABG, and lower triglycerides.
- 1-year MACE occurred in 4.1% of patients, with no significant difference between MPV tertiles.
- Highest MPV tertile predicted MACE in univariable analysis (HR=1.51, P=0.026) and was a borderline predictor in adjusted analysis (HR=1.62, P=0.057).
Conclusions:
- High MPV is associated with cardiovascular risk factors and older age.
- High MPV was a borderline independent predictor of 1-year MACE in elective PCI candidates.
Background:
Mean platelet volume (MPV) has been introduced as a simple and accurate method for assessing platelet function, which can be used as a prognostic marker for cardiovascular events. We investigated whether pre-procedural MPV could predict major adverse cardiac events (MACE) in candidates for elective percutaneous coronary intervention (PCI).
Methods:
In this large retrospective cohort, we reviewed the clinical and follow-up data of 4199 candidates (mean age = 59.9 ± 10.3 years; female patients = 1440 [34.3%]) for elective PCI due to unstable angina (UA) or non-ST segment elevation myocardial infarction (NSTEMI). The primary endpoint of the study was the incidence of MACE defined as in-hospital mortality, cardiac death, nonfatal MI, target lesion revascularization (TLR) or target vessel revascularization (TVR). Based on the MPV level tertiles, patients were categorized into three groups for further comparison.
Results:
Higher MPV was significantly associated with older age (P<0.001), hypertension (P<0.001), diabetes mellitus (P=0.003), history of previous CABG (P<0.001) and lower levels of serum triglyceride (P<0.001). The frequency of 1-year MACE was 176 (4.1%) with no significant difference between the MPV tertile groups. The highest MPV tertile could significantly predict MACE in the univariable model (hazard ratio = 1.51, 95% confidence interval: 1.05-2.17; P=0.026). In the adjusted model, the highest MPV tertile was a borderline predictor for MACE (hazard ratio = 1.62, 95% CI: 0.98-2.68; P=0.057).
Conclusion:
High MPV was associated with cardiovascular risk factors and older age while high MPV was a borderline independent predictor for 1-year MACE in the candidates for elective PCI.
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