This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: j.jacc.2005.03.065v1 46/2/284    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (18) Citing Articles via Google Scholar Google Scholar Articles by Huczek, Z. Articles by Opolski, G. Search for Related Content PubMed PubMed Citation Articles by Huczek, Z. Articles by Opolski, G.

CLINICAL RESEARCH: MYOCARDIAL INFARCTION

Mean Platelet Volume on Admission Predicts Impaired Reperfusion and Long-Term Mortality in Acute Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Zenon Huczek, MD^_*,_*, Janusz Kochman, MD^_*, Krzysztof J. Filipiak, MD, PhD^_*, Grzegorz J. Horszczaruk, MD^_*, Marcin Grabowski, MD^_*,, Radoslaw Piatkowski, MD^_*, Joanna Wilczynska, MD, PhD^_*, Andrzej Zielinski, MD^_*, Bernhard Meier, MD, FACC, FESC and Grzegorz Opolski, MD, PhD, FESC^_*

^_* 1st Department of Cardiology, The Medical University of Warsaw, Warsaw, Poland
Department of Medical Informatics, The Medical University of Warsaw, Warsaw, Poland
Department of Cardiology, Swiss Cardiovascular Center, Bern, Switzerland.

Manuscript received December 21, 2004; revised manuscript received March 15, 2005, accepted March 29, 2005.

^_* Reprint requests and correspondence: Dr. Zenon Huczek, Department of Cardiology, The Medical University of Warsaw, Central University Hospital, 1a Banacha Street, 02-097 Warszawa, Poland. (Email: zhuczek{at}wp.pl).

OBJECTIVES: We sought to determine the prognostic value of mean platelet volume (MPV) for angiographic reperfusion and six-month mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).

BACKGROUND: Mean platelet volume is predictive of unfavorable outcome among survivors of STEMI when measured after the index event. No data are available for the value of admission MPV in patients with STEMI treated with primary PCI.

METHODS: Blood samples for MPV estimation, obtained on admission in 398 consecutive patients presenting with STEMI, were measured before primary PCI. Follow-up up to six months was performed.

RESULTS: No-reflow was significantly more frequent in patients with high MPV (10.3 fl) compared with those with low MPV (<10.3 fl) (21.2% vs. 5.5%, p < 0.0001). The MPV was correlated strongly with corrected Thrombolysis In Myocardial Infarction frame count (CTFC) (r = 0.698, p < 0.0001). Kaplan-Meier survival analysis showed six-month mortality rate of 12.1% in patients with high MPV versus 5.1% in low MPV group (log rank = 6.235, p = 0.0125). After adjusting for baseline characteristics, high MPV remained a strong independent predictor of no-reflow (odds ratio [OR] 4.7, 95% confidence interval [CI] 2.3 to 9.9, p < 0.0001), CTFC 40 (OR 10.1, 95% CI 5.7 to 18.1, p < 0.0001), and mortality (OR 3.2, 95% CI 1.1 to 9.3, p = 0.0084). Abciximab administration resulted in significant mortality reduction only in patients with high MPV values (OR 0.02, 95% CI 0.01 to 0.48, p = 0.0165).

CONCLUSIONS: Mean platelet volume is a strong, independent predictor of impaired angiographic reperfusion and six-month mortality in STEMI treated with primary PCI. Apart from prognostic value, admission MPV may also carry further practical, therapeutic implications.

Abbreviations and Acronyms   CI = confidence interval   CTFC = corrected TIMI frame count   EDTA = ethylenedinitro tetraacetic acid   IRA = infarct-related artery   OR = odds ratio   MPV = mean platelet volume   PCI = percutaneous coronary intervention   ROC = receiver-operating characteristic   STEMI = ST-segment elevation myocardial infarction   TnI = troponin I

This article has been cited by other articles:

				S. Guthikonda, C. L. Alviar, M. Vaduganathan, M. Arikan, A. Tellez, T. DeLao, J. F. Granada, J.-F. Dong, N. S. Kleiman, and E. I. Lev 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., August 26, 2008; 52(9): 743 - 749. [Abstract] [Full Text] [PDF]

				G. Niccoli, S. Giubilato, E. Russo, C. Spaziani, A. Leo, I. Porto, A. M. Leone, F. Burzotta, S. Riondino, F. Pulcinelli, et al. Plasma levels of thromboxane A2 on admission are associated with no-reflow after primary percutaneous coronary intervention Eur. Heart J., August 1, 2008; 29(15): 1843 - 1850. [Abstract] [Full Text] [PDF]

				D. J. Kereiakes and P. A. Gurbel Peri-Procedural Platelet Function and Platelet Inhibition in Percutaneous Coronary Intervention J. Am. Coll. Cardiol. Intv., April 1, 2008; 1(2): 111 - 121. [Abstract] [Full Text] [PDF]

				A. Choudhury, I. Chung, A. D. Blann, and G. Y.H. Lip Platelet Surface CD62P and CD63, Mean Platelet Volume, and Soluble/Platelet P-Selectin as Indexes of Platelet Function in Atrial Fibrillation: A Comparison of "Healthy Control Subjects" and "Disease Control Subjects" in Sinus Rhythm J. Am. Coll. Cardiol., May 15, 2007; 49(19): 1957 - 1964. [Abstract] [Full Text] [PDF]

				M. Sezer, I. Okcular, T. Goren, H. Oflaz, Y. Nisanci, B. Umman, F. Mercanoglu, A. K Bilge, M. Meric, and S. Umman Association of haematological indices with the degree of microvascular injury in patients with acute anterior wall myocardial infarction treated with primary percutaneous coronary intervention Heart, March 1, 2007; 93(3): 313 - 318. [Abstract] [Full Text] [PDF]