title: Mean platelet volume may predict early clinical outcome after coronary artery bypass grafting.
abstract: BACKGROUND
  An elevated mean platelet volume is associated with increased platelet activation and thus may predict thrombotic events. The goal of this study was to investigate the association of the mean platelet volume and the major adverse events after coronary artery bypass surgery.
  
  
  METHODS
  Baseline clinical details and preoperative hematologic parameters were obtained prospectively in 205 consecutive patients undergoing coronary artery bypass surgery. Postoperative mortality and major adverse events were recorded in the early postoperative period (median of 72 days, interquartile range 58.5-109 days).
  
  
  RESULTS
  Combined adverse events occurred in 37 patients (18.0%) during the early follow-up. The preoperative mean platelet volume and hematocrit levels were found to be associated with postoperative adverse events (p<0.001 for both variables). In multivariate logistic regression models, the preoperative mean platelet volume and hematocrit levels were strong independent predictors of combined adverse events after surgery (respectively OR 1.89, p=0.037; OR 0.87, p=0.011). After receiver-operating-characteristics curve analysis, using a cut-point of 8.75 fL, the preoperative mean platelet volume level predicted adverse events with a sensitivity of 54% and specificity of 70%. In a further model with cut-off points, higher preoperative mean platelet volume levels remained a powerful independent predictor of postoperative myocardial infarction (OR 3.60, p=0.013) and major adverse cardiac events (OR 2.53, p=0.045).
  
  
  CONCLUSIONS
  An elevated preoperative mean platelet volume is associated with an adverse outcome after coronary artery bypass grafting. In conclusion, we can say that mean platelet volume is an important, simple, readily available, and cost effective tool and can be useful in predicting the postoperative adverse events in patients undergoing coronary artery bypass grafting.
authors.forename: Ertekin Utku
authors.initials: EU
authors.lastname: Unal
authors.forename: Anil
authors.initials: A
authors.lastname: Ozen
authors.forename: Sabit
authors.initials: S
authors.lastname: Kocabeyoglu
authors.forename: Ahmet Baris
authors.initials: AB
authors.lastname: Durukan
authors.forename: Sercan
authors.initials: S
authors.lastname: Tak
authors.forename: Murat
authors.initials: M
authors.lastname: Songur
authors.forename: Umit
authors.initials: U
authors.lastname: Kervan
authors.forename: Cemal Levent
authors.initials: CL
authors.lastname: Birincioglu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001026:Coronary Artery Bypass / Q000401:mortality; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000601:surgery*; D005260:Female; D006400:Hematocrit; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D057234:Preoperative Period; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors; D012680:Sensitivity and Specificity