title: Mean platelet volume is a predictor of ST resolution following thrombolysis in acute ST elevation myocardial infarction.
abstract: BACKGROUND
  Larger mean platelets volumes (MPV) are thrombogenic and frequently seen after ST-segment elevation myocardial infarction (STEMI). This study aimed to examine the association of MPV and resolution of ST-segment after thrombolysis in STEMI patients as and its impact on clinical outcome.
  
  
  METHODS
  Patients presenting to the emergency department with the diagnosis of first STEMI and were referred to thrombolysis were screened. Patients with ≥50% ST-segment resolution (STR) 90minutes after thrombolysis were assigned as "Responder" and those with <50% STR were assigned as "Non-Responders". Demographic, clinical comorbidities and risk factor were recorded along with and angiographic data. In-hospital occurrence of major adverse cardiac events (MACE), including acute heart failure (AHF), reinfarction and death were investigated. Additionally, the patients were followed for 6 additional months after their discharge from the hospital.
  
  
  RESULTS
  STR≥50% was seen in 60.2% of patients after thrombolysis. Responders had significantly lower MPV (P=0.001) and the critical MPV values were 8.0 femtoliter (fL) and 8.2fL in predicting STR and MACE. Patients with MPV ≥8.2fL had lower probability of STR and higher rates of AHF (P<0.001), and MACE (P=0.001) compared to the patients with lower platelet volume. In multivariate regression, MPV was an independent predictor of STR (P<0.001) as well as MACE (HR=4.8, 95% CI of 1.8-12.4; P=0.001). Triple vessel disease was another independent factor that predicted MACE.
  
  
  CONCLUSIONS
  Higher MPV's at admission were associated with lower STR and higher occurrence of major adverse cardiac events in patients receiving thrombolytic therapy for first time STEMI.
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad
authors.initials: S
authors.lastname: Ghaffari
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Leili
authors.initials: L
authors.lastname: Pourafkari
authors.affiliation: Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Javadzadegan
authors.affiliation: Tabriz University of Medical Sciences, Tabriz Iran.
authors.forename: Nayyer
authors.initials: N
authors.lastname: Masoumi
authors.affiliation: Tabriz University of Medical Sciences, Tabriz Iran.
authors.forename: Mohammad Asghari
authors.initials: MA
authors.lastname: Jafarabadi
authors.affiliation: University at Buffalo, 252 Farber Hall, Buffalo, NY 14214, USA. Electronic address: nnader@buffalo.edu.
authors.forename: Nader D
authors.initials: ND
authors.lastname: Nader
mesh_terms: D000368:Aged; D001792:Blood Platelets / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D011379:Prognosis; D015912:Thrombolytic Therapy
keywords: Major Adverse Cardiovascular Events; Mean Platelet Volume; Myocardial Infarction; ST segment resolution; thrombolysis