title: Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction.
abstract: Mean platelet volume (MPV) is a marker of platelet activation. An increased MPV is associated with acute myocardial infarction (AMI) and long-term mortality. The aim of this study was to compare MPV in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI). Also, we investigated the value of MPV on in-hospital mortality and long-term prognosis of patients with STEMI and NSTEMI. We studied 429 patients with AMI (70.4% male, 61.9 ± 12.4 years; 279 patients with STEMI, 150 patients with NSTEMI). MPV and platelet count were similar in both groups. Elevated MPV increased the risk of death by 3.1-fold (p < 0.001) in STEMI group during the hospitalization. However, increased MPV was not associated with in-hospital mortality in NSTEMI group. The area under the receiver operating characteristic curve of MPV was 0.868 (95% CI, 0.830-0.907) for predicting two-year mortality. A cut-off point of 11.1 fL showed a sensitivity of 81% and a specifity of 77% for prediction of two-year mortality. Kaplan-Meier survival curve showed two-year mortality rate of 12.5% in patients with MPV >11.1 fL versus 9.9% in patients with MPV <11.1 fL (p < 0.001). Cox regression analysis showed MPV to be an independent predictor of two-year mortality (Hazard ratio 1.7; 95% CI 1.5-1.9; p < 0.001). An increased MPV is an independent predictor of in-hospital mortality in patients with STEMI. However, elevated levels of MPV did not predict in hospital mortality in NSTEMI group. The increase in MPV values was independently correlated with two-year mortality in all study patients.
authors.affiliation: Dicle University Faculty of Medicine, Department of Cardiology, Diyarbakir, Turkey. dretekbas@yahoo.com
authors.forename: Ebru
authors.initials: E
authors.lastname: Tekbas
authors.forename: Ali F
authors.initials: AF
authors.lastname: Kara
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Ariturk
authors.forename: Habib
authors.initials: H
authors.lastname: Cil
authors.forename: Yahya
authors.initials: Y
authors.lastname: Islamoglu
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Elbey
authors.forename: Serdar
authors.initials: S
authors.lastname: Soydinc
authors.forename: Mehmet S
authors.initials: MS
authors.lastname: Ulgen
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D001792:Blood Platelets / Q000473:pathology*; D048429:Cell Size; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009203:Myocardial Infarction / Q000145:classification / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D015539:Platelet Activation; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology
chemical_list: D015415:Biomarkers