The Prognostic Value of Mean Platelet Volume in Acute Myocardial Infarction

Lee, Ju Hwan; Kim, Hyung Seop; Kwon, Yong Seop; Lee, Hyun Sang; Park, Man Gee; Heo, Jung Ho; Yang, Dong Heon; Park, Hun Sik; Cho, Yong Keun; Chae, Shung Chull; Jun, Jae Eun; Park, Wee Hyun

Abstract

BACKGROUND AND OBJECTIVES
An increased platelet volume is associated with increased platelet reactivity, and may influence the outcome following a myocardial infarction.
SUBJECTS AND METHODS
One hundred patients with acute myocardial infarction, who visited Kyungpook National University Hospital between 2001 January and 2001 December, were included in this study. To determine the mean platelet volume (MPV), blood samples, taken at the time of arrival, were analyzed in an automated haematology analysis system (CELL-DYN3000, ABBOTT, USA). EDTA in the blood bottles was used as an anticoagulant. All samples were processed within 30 minutes of venipuncture, to avoid bias due to platelet swelling. The patients were followed for one year for readmission due to acute coronary syndrome, congestive heart failure or death. To stratify the prognostic value of the MPV, the patients were divided into 4 equal groups according to the percentiles of the platelet volume.
RESULTS
Eight patients died, and 20 were readmitted due to acute coronary syndrome or congestive heart failure. The MPV is not a significant predictor of death. However, in the prediction of MACE, death and readmission, the MPV and age were significant factors (p<0.001 and p=0.046, respectively). The highest quartile group(MPV> 8.8fL) had a 7 times greater risk of MACE than the lowest quartile group (MPV<7.4 fL).
CONCLUSION
The MPV measured in the emergency room is a significant predictor of MACE with an acute myocardial infarction. Therefore, patients with a large MPV might require more intensive, closely controlled treatment strategies for secondary prevention.