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Two-year prognostic value of mean platelet volume in patients with diabetes and stable coronary artery disease undergoing elective percutaneous coronary intervention
Affiliations- State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Abstract
Background: Mean platelet volume (MPV) is a marker of platelet size and activity, and is associated with a poor prognosis of cardiovascular disease. Studies have shown a relationship between diabetes mellitus (DM) and MPV. This study examined the relationship between admission MPV and 2-year cardiac mortality in patients with DM and stable coronary artery disease (SCAD) undergoing elective percutaneous coronary intervention (PCI).
Methods: A total of 1389 patients were enrolled and divided into two groups according to MPV as fol- lows: lower MPV (n = 908, MPV ≤ 10.9 fL) and higher MPV (n = 481, MPV > 10.9 fL).
Results: Body mass index, platelet distribution width, MPV/platelet and glycated hemoglobin (HbA1c) levels were significantly higher in the higher MPV group compared with the lower MPV group (all p < 0.05). The platelet count was significantly lower in the higher MPV group compared with the lower MPV group (p < 0.05). MPV was positively associated with HbA1c and fasting plasma glucose levels (r = 0.073 and 0.061, p = 0.007 and 0.023, respectively) in bivariate correlation analysis. The 2-year cardiac mortality rate was 0.7%, and was significantly lower in the lower MPV group than in the higher MPV group in Kaplan-Meier analysis (p = 0.019). Receiver operating characteristic analysis showed a good diagnostic value for MPV at predicting long-term cardiac mortality (area under the curve: 0.735, 95% confidence interval [CI]: 0.590–0.880, p = 0.01). Elevated MPV was a significant risk factor for 2-year cardiac mortality (hazard ratio: 2.091, 95% CI: 1.075–4.070, p = 0.030) in multivariable Cox regression analysis.
Conclusions: Mean platelet volume is a strong, independent prognostic factor in PCI-treated patients with DM and SCAD.
Abstract
Background: Mean platelet volume (MPV) is a marker of platelet size and activity, and is associated with a poor prognosis of cardiovascular disease. Studies have shown a relationship between diabetes mellitus (DM) and MPV. This study examined the relationship between admission MPV and 2-year cardiac mortality in patients with DM and stable coronary artery disease (SCAD) undergoing elective percutaneous coronary intervention (PCI).
Methods: A total of 1389 patients were enrolled and divided into two groups according to MPV as fol- lows: lower MPV (n = 908, MPV ≤ 10.9 fL) and higher MPV (n = 481, MPV > 10.9 fL).
Results: Body mass index, platelet distribution width, MPV/platelet and glycated hemoglobin (HbA1c) levels were significantly higher in the higher MPV group compared with the lower MPV group (all p < 0.05). The platelet count was significantly lower in the higher MPV group compared with the lower MPV group (p < 0.05). MPV was positively associated with HbA1c and fasting plasma glucose levels (r = 0.073 and 0.061, p = 0.007 and 0.023, respectively) in bivariate correlation analysis. The 2-year cardiac mortality rate was 0.7%, and was significantly lower in the lower MPV group than in the higher MPV group in Kaplan-Meier analysis (p = 0.019). Receiver operating characteristic analysis showed a good diagnostic value for MPV at predicting long-term cardiac mortality (area under the curve: 0.735, 95% confidence interval [CI]: 0.590–0.880, p = 0.01). Elevated MPV was a significant risk factor for 2-year cardiac mortality (hazard ratio: 2.091, 95% CI: 1.075–4.070, p = 0.030) in multivariable Cox regression analysis.
Conclusions: Mean platelet volume is a strong, independent prognostic factor in PCI-treated patients with DM and SCAD.
Keywords
diabetes mellitus; stable coronary artery disease; cardiac mortality; percutaneous coronary intervention
About this articleTitle
Two-year prognostic value of mean platelet volume in patients with diabetes and stable coronary artery disease undergoing elective percutaneous coronary intervention
Journal
Issue
Pages
138-146
Published online
2018-07-13
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3078
Article views/downloads
1479
DOI
10.5603/CJ.a2018.0071
Pubmed
Bibliographic record
Cardiol J 2019;26(2):138-146.
Keywords
diabetes mellitus
stable coronary artery disease
cardiac mortality
percutaneous coronary intervention
Authors
Ping Jiang
Ying Song
Jing-Jing Xu
Huan-Huan Wang
Lin Jiang
Wei Zhao
Xue-Yan Zhao
Jue Chen
Zhan Gao
Shu-Bin Qiao
Yue-Jin Yang
Run-Lin Gao
Bo Xu
Jin-Qing Yuan
References (31)- Falk E. Pathogenesis of atherosclerosis. J Am Coll Cardiol. 2006; 47(8 Suppl): C7–12.
- Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet. 1991; 338(8780): 1409–1411.
- Chu SG, Becker RC, Berger PB, et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010; 8(1): 148–156.
- Jakubowski JA, Adler B, Thompson CB, et al. Influence of platelet volume on the ability of prostacyclin to inhibit platelet aggregation and the release reaction. J Lab Clin Med. 1985; 105(2): 271–276.
- Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996; 7(2): 157–161.
- Lekston A, Hudzik B, Hawranek M, et al. Prognostic significance of mean platelet volume in diabetic patients with ST-elevation myocardial infarction. J Diabetes Complications. 2014; 28(5): 652–657.
- Ferreiro JL, Angiolillo DJ. Diabetes and Antiplatelet Therapy in Acute Coronary Syndrome. Circulation. 2011; 123(7): 798–813.
- Yüksel Kalkan G, Gür M, Baykan AO, et al. Mean platelet volume is associated with aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease. Anatol J Cardiol. 2015; 15(9): 753–758.
- Endler G, Klimesch A, Sunder-Plassmann H, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002; 117(2): 399–404.
- De Luca G, Santagostino M, Secco GG, et al. Mean platelet volume and the extent of coronary artery disease: results from a large prospective study. Atherosclerosis. 2009; 206(1): 292–297.
- Ndrepepa G, Tiroch K, Fusaro M, et al. 5-year prognostic value of no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction. J Am Coll Cardiol. 2010; 55(21): 2383–2389.
- Eisen A, Bental T, Assali A, et al. Mean platelet volume as a predictor for long-term outcome after percutaneous coronary intervention. J Thromb Thrombolysis. 2013; 36(4): 469–474.
- Rechciński T, Jasińska A, Foryś J, et al. Prognostic value of platelet indices after acute myocardial infarction treated with primary percutaneous coronary intervention. Cardiol J. 2013; 20(5): 491–498.
- Park DW, Park SW, Park KH, et al. Frequency of and risk factors for stent thrombosis after drug-eluting stent implantation during long-term follow-up. Am J Cardiol. 2006; 98(3): 352–356.
- Park DW, Flaherty JD, Davidson CJ, et al. Prognostic influence of diabetes mellitus on long-term clinical outcomes and stent thrombosis after drug-eluting stent implantation in asian patients. Am J Cardiol. 2009; 103(5): 646–652.
- Rydén L, Standl E, Bartnik M, et al. Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC), European Association for the Study of Diabetes (EASD). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary. The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J. 2007; 28(1): 88–136.
- Montalescot G, Sechtem U, Achenbach S, et al. Task Force Members, ESC Committee for Practice Guidelines, Document Reviewers. 2013 ESC guidelines on the management of stable coronary artery disease: the Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013; 34(38): 2949–3003.
- Coban E, Bostan F, Ozdogan M. The mean platelet volume in subjects with impaired fasting glucose. Platelets. 2009; 17(1): 67–69.
- Coban E, Ozdogan M, Yazicioglu G, et al. The mean platelet volume in patients with obesity. Int J Clin Pract. 2005; 59(8): 981–982.
- Nadar SK, Blann AD, Kamath S, et al. Platelet indexes in relation to target organ damage in high-risk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol. 2004; 44(2): 415–422.
- Shimodaira M, Niwa T, Nakajima K, et al. Correlation between mean platelet volume and fasting plasma glucose levels in prediabetic and normoglycemic individuals. Cardiovasc Diabetol. 2013; 12: 14.
- Verdoia M, Schaffer A, Barbieri L, et al. Novara Atherosclerosis Study (NAS) group. Diabetes, glucose control and mean platelet volume: a single-centre cohort study. Diabetes Res Clin Pract. 2014; 104(2): 288–294.
- Sahin DY, Gür M, Elbasan Z, et al. Mean platelet volume and extent and complexity of coronary artery disease in diabetic and nondiabetic patients with ST elevation myocardial infarction. Angiology. 2013; 64(7): 505–511.
- Abalı G, Akpınar O, Söylemez N. Correlation of the coronary severity scores and mean platelet volume in diabetes mellitus. Adv Ther. 2014; 31(1): 140–148.
- Ki YJ, Park S, Ha SI, et al. Usefulness of mean platelet volume as a biomarker for long-term clinical outcomes after percutaneous coronary intervention in Korean cohort: a comparable and additive predictive value to high-sensitivity cardiac troponin T and N-terminal pro-B type natriuretic peptide. Platelets. 2014; 25(6): 427–432.
- Sansanayudh N, Numthavaj P, Muntham D, et al. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost. 2015; 114(6): 1299–1309.
- Shah B, Oberweis B, Tummala L, et al. Mean platelet volume and long-term mortality in patients undergoing percutaneous coronary intervention. Am J Cardiol. 2013; 111(2): 185–189.
- Grove EL, Hvas AM, Mortensen SB, et al. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Haemost. 2011; 9(1): 185–191.
- Guthikonda S, Lev EI, Patel R, et al. Reticulated platelets and uninhibited COX-1 and COX-2 decrease the antiplatelet effects of aspirin. J Thromb Haemost. 2007; 5(3): 490–496.
- Guthikonda S, Alviar CL, Vaduganathan M, et al. Role of reticulated platelets and platelet size heterogeneity on platelet activity after dual antiplatelet therapy with aspirin and clopidogrel in patients with stable coronary artery disease. J Am Coll Cardiol. 2008; 52(9): 743–749.
- Vinik AI, Erbas T, Park TS, et al. Platelet dysfunction in type 2 diabetes. Diabetes Care. 2001; 24(8): 1476–1485.
