J Korean Soc Emerg Med.  2017 Oct;28(5):514-525. 10.0000/jksem.2017.28.5.514.

Usefulness of Serial Measurement of the Platelet Volume Indices to Predict 30-day Mortality in Patients with ST Segment Elevation Myocardial Infarction

• Yu G
• You JS
• Chung SP
• Kong T
• Ko D
• Kim S
• Joo Y
• Hwang YJ
• Choa M
• Park I

• KMID: 2394400
• DOI: http://doi.org/10.0000/jksem.2017.28.5.514

Abstract

PURPOSE
Among the survivors of a ST elevation myocardial infarction (STEMI), higher platelet volume indices (mean platelet volume, MPV; platelet distribution width, PDW) are associated with impaired reperfusion and ventricular dysfunction. This study examined the relationship between the platelet volume indices and 30-day mortality with STEMI patients who underwent primary percutaneous coronary intervention (PCI).
METHODS
This retrospective cohort study included patients presenting to the emergency department with STEMI between January 2011 and May 2016. The platelet volume indices were measured serially, using an automatic hematology analyzer, from admission to 24 hours after admission. The prognostic value of MPV, PDW for the 30-day mortality was determined by Cox proportional hazards model analysis.
RESULTS
A total of 608 STEMI patients, who underwent reperfusion, were enrolled in this study. According to the multivariable Cox proportional hazard model, higher MPV (hazard ratio [HR], 1.414; 95% confidence interval [CI], 1.024-1.953; p=0.035) and PDW (HR, 1.043; 95% CI, 1.006-1.083; p=0.024) values at time-24 (24 hours after admission) were significant risk factors for the 30-day mortality. A MPV value >8.6 fL (HR, 5.953; 95% CI, 2.973-11.918; p<0.001) and PDW value >56.1% (HR, 5.117; 95% CI, 2.640-9.918; p<0.001) at time-24 were associated with an increased risk of 30-day mortality.
CONCLUSION
The platelet volume indices without an additional burden of cost or time, can be measured rapidly and simply. Higher MPV and PDW levels predict independently the 30-day mortality in patients with STEMI after PCI.

Keyword

ST Elevation myocardial infarction; Mean platelet volume; Platelet activation; Prognosis

MeSH Terms

Blood Platelets*
Cohort Studies
Emergency Service, Hospital
Hematology
Humans
Mean Platelet Volume
Mortality*
Myocardial Infarction*
Percutaneous Coronary Intervention
Platelet Activation
Prognosis
Proportional Hazards Models
Reperfusion
Retrospective Studies
Risk Factors
Survivors
Ventricular Dysfunction