title: Could an analysis of mean corpuscular volume help to improve risk stratification in non-anemic patients with acute myocardial infarction?
abstract: BACKGROUND
  Nowadays, when the majority of patients with acute myocardial infarction (AMI) are treated with primary percutaneous coronary intervention and modern pharmacotherapy, risk stratification becomes a challenge. Simple and easily accessible parameters that would help in a better determination of prognosis are needed. The aim of the study was to estimate the prevalence of high mean corpuscular volume (MCV, defined as MCV > 92 fL) and to establish its prognostic value in non-anemic patients with AMI.
  
  
  METHODS
  We retrospectively analyzed the data of 248 consecutive non-anemic patients hospitalized due to AMI (median age: 65 [59-76] years, men: 63%, ST segment elevation myocardial infarction: 31%, and median left ventricular ejection fraction [LVEF]: 50%).
  
  
  RESULTS
  The prevalence of high MCV was 39 ± 6% (± 95% confidence interval) in the entire AMI population. High MCV was more prevalent in males, patients with low body mass index, non-diabetics and cigarette smokers (all p < 0.05). During the 180-day follow-up, there were 38 (15%) events, defined as another AMI or death. In a multivariable Cox proportional hazard model, female gender (p < 0.01), low LVEF (p < 0.001), previous AMI (p < 0.05), arterial hypertension (p < 0.05), and high MCV (p < 0.001) were prognosticators of pre-defined events.
  
  
  CONCLUSIONS
  In non-anemic patients with AMI, high MCV is an independent prognostic factor of poor outcome defined as another AMI or death.
authors.forename: Paweł
authors.initials: P
authors.lastname: Franczuk
authors.forename: Maciej
authors.initials: M
authors.lastname: Kaczorowski
authors.forename: Karolina
authors.initials: K
authors.lastname: Kucharska
authors.forename: Jolanta
authors.initials: J
authors.lastname: Franczuk
authors.forename: Krystian
authors.initials: K
authors.lastname: Josiak
authors.forename: Wojciech
authors.initials: W
authors.lastname: Zimoch
authors.forename: Michał
authors.initials: M
authors.lastname: Kosowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Reczuch
authors.forename: Jacek
authors.initials: J
authors.lastname: Majda
authors.forename: Waldemar
authors.initials: W
authors.lastname: Banasiak
authors.forename: Piotr
authors.initials: P
authors.lastname: Ponikowski
authors.affiliation: Cardiology Department, Centre for Heart Diseases, 4th Military Hospital, Wroclaw, Poland Laboratory for Applied R esearch on Cardiovascular System, Depar tment of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland. ewa.jankowska@umed.wroc.pl.
authors.forename: Ewa A
authors.initials: EA
authors.lastname: Jankowska
keywords: acute myocardial infarction; anemia; mean corpuscular volume; risk stratification