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Updated: Nov 2, 2025
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Joint effect of platelet distribution width and stent surface area on major adverse cardiovascular events after
Xiaofeng Zhang1, Haiyan Ge2, Xiaoxuan Gong3
1Department of Cardiology First Affiliated Hospital of Nanjing Medical University, Nanjing, China; The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China.
Insights
The combined effect of stent surface area (SSA) and platelet distribution width (PDW) significantly impacts major adverse cardiovascular events (MACEs) after drug-eluting stent implantation. Higher SSA and lower PDW may reduce MACE risk.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomarkers in Cardiology
Background:
- Major adverse cardiovascular events (MACEs) remain a concern following percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation.
- Stent surface area (SSA) and platelet distribution width (PDW) are potential risk factors influencing MACEs.
Purpose of the Study:
- To analyze the individual and combined effects of SSA and PDW on MACEs in patients undergoing PCI with DES.
- To identify risk stratification strategies based on these parameters.
Main Methods:
- A prospective cohort study of 442 patients who underwent PCI with DES implantation.
- Patients were categorized into four subgroups based on PDW and SSA levels.
- Cox proportional hazards models were used to assess the correlation between PDW, SSA, and MACE incidence.
Main Results:
- During 12-month follow-up, 87 patients experienced MACEs. SSA showed a trend towards decreasing MACE risk, while PDW showed a trend towards increasing it.
- The combined effect was significant: patients with low PDW (<13.5%) and high SSA (≥358.14 mm²) had a multivariable adjusted HR of 0.37 for MACEs.
- Specific subgroups also showed significant correlations with 12-month bleeding events.
Conclusions:
- The joint effect of PDW and SSA is significantly correlated with MACE development in patients treated with PCI and DES implantation.
- This combined assessment may aid in predicting MACE risk and guiding clinical decisions.
Background:
This study was conducted to analyze the influences of stent surface area (SSA), platelet distribution width (PDW), and the joint effect of these 2 risk factors on major adverse cardiovascular events (MACEs) in patients treated with percutaneous coronary intervention (PCI) together with drug-eluting stent (DES) implantation.
Methods:
Based on a cross-sectional survey conducted between 2011 and 2012, a prospective cohort study was enrolled consiting of 442 patients who had undergone PCI with DES implantation. We categorized the participants into 4 subgroups according to PDW and SSA. Cox proportional hazards models were applied to explore the correlation of PDW and SSA with MACE incidence.
Results:
During the 12 months of follow-up time, 87 patients experienced MACEs, which included 4 deaths (4.6%), 5 nonfatal myocardial infarctions (MIs) (5.75%), 9 ischemic strokes (10.34%), and 73 clinically relevant bleeding episodes (83.91%). The risks of MACEs were decreased by SSA and increased by PDW. However, the association of PDW or SSA with MACE was not statistically significant. Compared with the patients with PDW ≥13.5% and SSA <358.14 mm2, the multivariable adjusted hazard ratios [HRs; 95% confience interval (CI)] of the total MACEs for the patients with PDW <13.5% and SSA ≥358.14 mm2, and with PDW ≥13.5% and SSA ≥358.14 mm2 were 0.94 (95% CI: 0.55-1.64) and 0.37 (95% CI: 0.18-0.76), respectively. Additionally, the patients in the group of PDW <13.5% and SSA <358.14 mm2, and PDW ≥13.5% and SSA ≥358.14 mm2 had respective HRs of 0.47 (95% CI: 0.24-0.91) and 0.28 (95% CI: 0.13-0.63) for 12-month bleeding events when PDW ≥13.5% and SSA <358.14 mm2was used as a group reference.
Conclusions:
Our present results suggest that the joint effect of PDW and SSA was significantly correlated to MACE development in the patients treated with PCI (with DES implantation).
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