title: Mean platelet volume is associated with poor postinterventional myocardial blush grade in patients with ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  In a significant proportion of patients with ST-elevation myocardial infarction (STEMI), microvascular and myocardial reperfusion cannot be regained despite successfully restored thrombolysis in myocardial infarction (TIMI) grade 3 epicardial blood flow. Myocardial blush grade (MBG) is a reliable marker for microvascular patency and predicts short-term and long-term mortality after primary percutaneous coronary intervention (PCI) in patients with acute STEMI, independent of other variables. Mean platelet volume (MPV), a unique measure of platelet size, is an indicator of platelet reactivity. In this study, we aimed to investigate the relation of admission MPV with postinterventional MBG in patients with STEMI and TIMI grade 3 flow at infarct artery after primary PCI.
  
  
  METHODS
  Three hundred and ten patients were selected as a study group among patients with STEMI and TIMI grade 3 epicardial blood flow after primary PCI. Blood samples for analysis were obtained during the initial evaluation of patients at the emergency department. MBGs of patients were classified at the end of angioplasty. Patients with MBG 0 and 1 were defined as having poor myocardial blush and patients with MBG 2 and 3 were defined as having normal myocardial blush.
  
  
  RESULTS
  Patients with poor myocardial blush had higher admission MPV (10.5±1.3 to 9.1±1 fl, P<0.001), higher peak creatine kinase myocardial band isoenzyme levels (260±53 to 190±38 U/l, P<0.001), higher white blood cell count (11.3±4 to 10.3±3×10/μl, P=0.012), and lower left ventricular ejection fraction (42±7 to 51±8%, P<0.001) compared with patients with normal myocardial blush. Linear regression analysis showed that admission MPV was significantly associated with postinterventional MBG (coefficient=0.598, P<0.001). Cardiovascular mortality (13-5%, P=0.013) and acute-subacute stent thrombosis at 3 months (12-8%, P=0.028) were significantly higher in patients with poor postinterventional myocardial blush compared with those with normal myocardial blush.
  
  
  CONCLUSIONS
  The MPV measured at admission is significantly associated with poor postinterventional MBG in patients with STEMI and TIMI grade 3 flow at infarct artery after primary PCI.
authors.affiliation: Department of Cardiology, Kayseri Education and Research Hospital, 38010 Kayseri, Turkey. drsarli@yahoo.com
authors.forename: Bahadir
authors.initials: B
authors.lastname: Sarli
authors.forename: Ahmet O
authors.initials: AO
authors.lastname: Baktir
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Saglam
authors.forename: Huseyin
authors.initials: H
authors.lastname: Arinc
authors.forename: Serkan
authors.initials: S
authors.lastname: Kurtul
authors.forename: Serdar
authors.initials: S
authors.lastname: Sivgin
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Mehmet G
authors.initials: MG
authors.lastname: Kaya
mesh_terms: D000368:Aged; D017130:Angioplasty; D001792:Blood Platelets / Q000166:cytology*; D048429:Cell Size; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D012720:Severity of Illness Index; D015607:Stents