Influence of platelet size before coronary angioplasty on subsequent restenosis

Platelet size has been shown to reflect platelet activity. We prospectively measured the mean platelet volume (MPV) in 47 patients undergoing single vessel angioplasty for symptomatic angina. The patients underwent repeat angiography 4-8 months later irrespective of symptomatic status. Restenosis was assessed quantitatively by hand held calliper measurements of the lesion and qualitatively by a return of angina, ST segment changes on an exercise test and visual analysis of the lesion severity by two experienced angiographers. Twenty-four patients developed recurrent angina during the follow-up period, the MPV in the group with chest pain was 8.54 +/- 0.60 fl compared to 8.1 +/- 0.69 fl in the asymptomatic group (P = 0.04). Twenty two patients had significant ST segment changes at exercise. In this group the MPV was 8.6 +/- 0.56 fl compared to 8.0 +/- 0.70 fl for the group with a negative test (P = 0.002). Similarly visually assessed angiographic stenosis showed a significant increase in the restenotic group (8.6 +/- 0.56 vs. 8.0 +/- 0.61 fl, P = 0.001). The relative odds for developing clinically defined restenosis were 10.2 times greater if the pre-procedural MPV lay in the upper compared to the lowest quartile. There was a positive correlation between MPV and change in minimal luminal diameter between post angioplasty and follow-up angiography, assessed quantitatively, r = +0.56, P = 0.016. There was no association between clinical or angiographic definitions of restenosis and haemoglobin, red cell count, mean corpuscular volume, white cell count or platelet count. Platelet size may influence the development of restenosis after successful coronary angioplasty.