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The MAPH Score Predicts Coronary Slow Flow. A Retrospective Case-Controlled Study
Mustafa Kaplangoray1, Kenan Toprak2, Cihan Aydın3
1Bilecik Şeyh Edebali University, Faculty of Medicine.
Insights
The new MAPH score, combining mean platelet volume, hematocrit, and total protein, effectively identifies coronary slow flow phenomenon (CSF). This score shows better predictive performance than individual markers for diagnosing CSF.
Area of Science:
- Cardiology
- Biomedical Engineering
- Clinical Diagnostics
Background:
- Coronary slow flow phenomenon (CSF) is a condition affecting coronary blood flow.
- Whole blood viscosity (WBV) markers like mean platelet volume (MPV), hematocrit, and total protein are implicated in cardiovascular health.
- A novel score integrating these WBV markers could improve CSF diagnosis.
Purpose of the Study:
- To develop and validate the MAPH score, integrating MPV, hematocrit, and total protein.
- To investigate the association between the MAPH score and the presence of CSF.
- To compare the diagnostic performance of the MAPH score against individual markers for CSF.
Main Methods:
- A study cohort of 201 patients was analyzed, with 105 diagnosed with CSF and 96 with normal coronary flow (NCF).
- Coronary flow was assessed using the Thrombolysis in Myocardial Infarction frame count (TFC) method.
- The MAPH score was calculated based on cut-off values for MPV, hematocrit, and total protein, determined via Youden's index.
Main Results:
- The CSF group exhibited significantly higher levels of total protein, MPV, hematocrit, and calculated shear rates (HSR, LSR) compared to the NCF group.
- Receiver operating characteristic (ROC) curve analysis demonstrated that the MAPH score significantly outperformed individual parameters in predicting CSF.
- The MAPH score showed superior performance in identifying patients with CSF.
Conclusions:
- The MAPH score is a novel and effective tool for identifying the presence of coronary slow flow phenomenon (CSF).
- This integrated score offers improved diagnostic capability compared to assessing individual WBV markers.
- The MAPH score holds potential for clinical application in the diagnosis of CSF.
Aim:
The MAPH score is a new score that combines mean platelet volume (MPV), hematocrit, and total protein, which are markers of whole blood viscosity (WBV). We aimed to investigate the relationship between the MAPH score and the coronary slow flow phenomenon (CSF).
Material And Methods:
A total of 201 patients were included in the study. 105 had CSF and 96 had normal coronary flow (NCF). Coronary flow was measured by the Thrombolysis in Myocardial Infarction frame count (TFC) method. The patients' MPV, age, hematocrit, and total protein were recorded. High (HSR) and low shear rates (LSR) were calculated, based on total protein and hematocrit values. Cut-off values for CSF were determined using the Youden's index, and the score was determined as 0 or 1 according to the cut-off values. The sum of these scores was the MAPH score.
Results:
The mean age of the patients included in the study was 51.1±7.9 (n=201, 54.2 % male). Hyperlipidemia, DM, and HT rates of both groups were similar, but the mean age of the CSF group was higher (p=0.773; p=0.549; p=0.848; p <0.001, respectively). Total protein, MPV, hematocrit, HSR and LSR were higher in the CSF group (p< 0.001, for all values). Comparative receiver operating characteristic (ROC) curve analysis showed that the performance of the MAPH score in predicting CSF is better than the performance of these parameters separately.
Conclusion:
A new score, the MAPH score, may be used to identify the presence of CSF.
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