title: Mean platelet volume and the risk of periprocedural myocardial infarction in patients undergoing coronary angioplasty.
abstract: BACKGROUND
  Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI). Mean platelet volume (MPV) has been proposed as a marker for platelet activation, as larger sized platelets have been associated with higher pro-thrombotic risk. Therefore, aim of the current study was to evaluate whether MPV is associated with increased risk of PMI after PCI.
  
  
  METHODS
  We included 1056 consecutive patients undergoing PCI. We measured myonecrosis biomarkers at intervals from 6 to 48 h after PCI. Periprocedural myonecrosis was defined for troponin I increase by 3 times the ULN or by 50% if elevated at the time of the procedure. PMI was defined as CK-MB increase by 3 times the ULN or 50% if elevated at the time of the procedure.
  
  
  RESULTS
  We grouped patients according to tertiles values of MPV (<10.4 fl; 10.5-11.3 fl; >11.4 fl). High MPV was associated with diabetes (p = 0.025) and higher prevalence of cerebrovascular events (p = 0.005). MPV significantly related with haemoglobin levels (p < 0.001), but inversely to platelet count (p < 0.001) and higher presence of thrombus (p = 0.03). Larger sized platelets did not increase risk of periprocedural myonecrosis (p = 0.91; OR[95% CI] = 1.04[0.90-1.2], p = 0.64) or PMI (p = 0.09; OR[95%IC] = 1.13[0.93-1.37]; p = 0.20). Subgroup analysis confirmed no impact of MPV on periprocedural MI also in high-risk subsets of patients, such as those with ACS at presentation (OR[95%CI] = 1.09 [0.87-1.38]; p = 0.44), diabetes (OR[95% CI] = 1.02[0.71-1.47], p = 0.91), female gender (OR [95% CI] = 1.15 [0.78-1.71], p = 0.48), elderly patients (age ≥ 75 years) (OR[95%CI] = 1.21[0.87-1.69], p = 0.25) or with renal failure (OR[95%CI] = 1.55[0.91-2.61], p = 0.1).
  
  
  CONCLUSIONS
  This study demonstrates that MPV does not predict the risk of PMI in patients undergoing PCI.
authors.affiliation: Division of Cardiology, Azienda Ospedaliera-Universitaria Maggiore della Carità, Cso Mazzini 18, Eastern Piedmont University, Novara 28100, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Verdoia
authors.forename: Cyril
authors.initials: C
authors.lastname: Camaro
authors.forename: Lucia
authors.initials: L
authors.lastname: Barbieri
authors.forename: Alon
authors.initials: A
authors.lastname: Schaffer
authors.forename: Paolo
authors.initials: P
authors.lastname: Marino
authors.forename: Giorgio
authors.initials: G
authors.lastname: Bellomo
authors.forename: Harry
authors.initials: H
authors.lastname: Suryapranata
authors.forename: Giuseppe
authors.initials: G
authors.lastname: De Luca
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000166:cytology* / Q000502:physiology; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology / Q000628:therapy; D015539:Platelet Activation / Q000502:physiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form