Mean Platelet Volume as Prognostic Marker in Patients with Acute Coronary Syndrome

1. Chirino Navarta, Daniel Agustín; Servicio de Cardiología de la Unidad Asistencial Por Más Salud Dr. César Milstein, Ciudad Autónoma de Buenos Aires; Servicio de Cardiología del Sanatorio Franchín, Ciudad Autónoma de Buenos Aires;
2. Monteros, Ariel ³
3. Trejo, Graciela ⁴
4. Baglioni, Florencia ⁵
5. Murua, Alicia ⁵
6. Leonardi, Mariela ⁶
7. Rodriguez Vazquez, Maria Luisa ²
8. Dizeo, Claudio ¹

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DOI: 10.7775/AJC.83.4.5545 DIALNET GOOGLE SCHOLAR lock_openDialnet editor

Abstract

  Background: Mean platelet volume (MPV) has been described as a predictor of cardiovascular events in patients with acute coronary syndrome. However, there is limited evidence of its role as prognostic marker in elderly patients. Objective: The aim of this study was to evaluate whether MPV is an independent predictor of events during follow-up of patients over 65 years of age with acute coronary syndrome. Methods: This prospective study included patients over 65 years with ST-segment elevation or non ST-segment elevation acute coronary syndrome. They were divided into two groups: high MPV (10.9 fL- 3rd tertile) and low MPV (<10.9 fL -1st and 2nd tertile). Different clinical variables were analyzed and the TIMI and GRACE scores were calculated. The primary endpoint was the composite of all-cause mortality and cardiovascular readmission (for acute coronary syndrome, heart failure and stroke) over the follow-up period. Results: A total of 250 patients were included in the study. Mean age was 74±7 years and 44% were women. Eighty-five patients presented with high and 165 with low MPV. Median follow-up was 302 days (interquartile range 130-558) and the primary endpoint was observed in 17.6% of cases (44 patients). In the multivariate Cox regression analysis, high MPV [HR 7.23 (95% CI 2.47-11.6); p=0.001], and TIMI [HR 3.10 (95% CI 1.46-6.59); p=0.03] and GRACE [HR 1.02 (95% CI 1.01-1.07); p=0.002] high risk scores were independent predictors of the primary endpoint. The area under the curve for MPV was 0.71 (95% CI 0.59-0.82), p=0.001. Conclusions: In our population, MPV emerged as an independent predictor of the composite endpoint, adjusted for other variables as the TIMI and GRACE scores.

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