Abstract
Background
Coronary artery disease (CAD) represents a leading cause of death worldwide. Given it adverse prognosis, risk stratification of patients with an acute coronary syndrome (ACS) remains a challenging issue. In this regard, different biomarkers are becoming more and more important in the diagnosis, assessment and outcome prediction. For the development of atherothrombosis, platelets have a huge part to play. Mean platelet volume (MPV), a unique measure of platelet size, is an indicator of platelet reactivity and suggests that MPV could be a biomarker of the risk and prognosis of patients with STEMI.
Aim and Objectives:to test the predictive value of MPV for angiographic thrombus burden and short term outcomes in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).
Patients and Methods
all patients presented with acute STEMI to the cardiology department of Ain Shams university hospitals, with Pain to door time less than 12 hours and underwent PPCI. MPV was measured on admission. Angiographic thrombus burden and post interventional thrombolysis in myocardial infarction (TIMI) flow grade and myocardial blush grade (MBG) were recorded. Patients were followed up for 3 to 6 months.
Results This study included 72 patients with STEMI who underwent PPCI. The patients’ ages ranged between 33 and 73 years old (mean age 53.22 ± 9.96years). This study included 62 males and 10 females. The MPV of the studied cases was 9.97 ± 1.31 fl. MPV was higher among patients with HTB (11.42±1.007 vs. 9.53±1.039.P 0.00) and patients with (MBG (0-1) and TIMI flow>3) (10.59±1.839vs. 9.81±1.092, P 0.004 and 10.49±1.191vs. 9.81±1.309, P 0.04 respectively).with short term follow up12 patients had heart failure requiring hospitalization and they had a higher MPV (10.81 ± 1.21 vs. 9.74 ± 1.3, p 0.01). In binary logistic regression analysis, the MPV was an independent predictor of TG after STEMI (odds ratio 7.278, and P value (0.000), CI (2.518-21.036)).
Conclusion
MPV may be a useful biomarker that can help in identification of higher-risk patients with large intracoronary thrombus burden, who might require more potent antiplatelet therapy.
USEFULNESS OF MEAN PLATELET VOLUME AS A BIOMARKER FOR ANGIOGRAPHIC THROMBUS BURDEN AND SHORT-TERM MORTALITY IN PATIENTS WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
