title: Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection.
abstract: Type A acute aortic dissection is a life-threatening vascular emergency because of its high morbidity and mortality. Platelet is a pivotal ingredient involved in the development of acute aortic dissection. In this study, we aimed to investigate whether mean platelet volume (MPV)/platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection. In this single-center and prospective cohort study, 106 consecutive patients with Stanford type A acute aortic dissection admitted to the hospital within 12 h after onset were recruited. The best cut-off value of MPV/platelet count ratio predicting all-cause mortality was determined by the receiver operator characteristic analysis. Patients were divided into high (H-MPV/platelet count) and low (L-MPV/platelet count) groups based on the cut-off value of 7.49 (10 fl/10/l). Patients were followed up for 3.5 years. Of the 106 acute aortic dissection patients, 71 (67.0%) died during the study period, with a median follow-up duration of 570 days. Compared to the L-MPV/platelet count group, patients with H-MPV/platelet count had a higher risk of in-hospital complications including hypotension, hypoxemia, myocardial ischemia/infarction, conscious disturbance, pericardial tamponade, paraplegia, and poor survival (all P < 0.05). In multivariable Cox regression models adjusted for potential confounders, MPV/platelet count ratio was positively associated with the hazard of all-cause mortality, irrespective of interventions either with medication only or urgent surgery, and the hazard ratios were 2.81 (95% confidence interval 1.28-4.48) for the H-MPV/platelet count group when taking L-MPV/platelet count group as the reference (P = 0.005). The MPV/platelet count ratio was a strong independent predictor for in-hospital complications and long-term mortality in patients with type A acute aortic dissection.
authors.affiliation: aDepartment of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi bDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu cXinjiang Key Laboratory of Cardiovascular Disease Research dClinical Research Institute of Xinjiang Medical University, Urumqi, China eBaker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia *Dong-Ze Li and Qing-Jie Chen contributed equally to the writing of this article.
authors.forename: Dong-Ze
authors.initials: DZ
authors.lastname: Li
authors.forename: Qing-Jie
authors.initials: QJ
authors.lastname: Chen
authors.forename: Hui-Ping
authors.initials: HP
authors.lastname: Sun
authors.forename: Rui
authors.initials: R
authors.lastname: Zeng
authors.forename: Zhi
authors.initials: Z
authors.lastname: Zeng
authors.forename: Xiao-Ming
authors.initials: XM
authors.lastname: Gao
authors.forename: Yi-Tong
authors.initials: YT
authors.lastname: Ma
authors.forename: Yi-Ning
authors.initials: YN
authors.lastname: Yang
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D001011:Aorta / Q000187:drug effects / Q000473:pathology / Q000601:surgery; D001014:Aortic Aneurysm / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D001241:Aspirin / Q000627:therapeutic use; D015415:Biomarkers / Q000032:analysis; D001792:Blood Platelets / Q000473:pathology; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002305:Cardiac Tamponade / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D010264:Paraplegia / Q000188:drug therapy / Q000209:etiology* / Q000401:mortality / Q000601:surgery; D010976:Platelet Count; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012372:ROC Curve
chemical_list: D000319:Adrenergic beta-Antagonists; D015415:Biomarkers; D002121:Calcium Channel Blockers; D001241:Aspirin