Mean platelet volume and cardiovascular outcomes in acute myocardial infarction.
OBJECTIVE
High levels of mean platelet volume (MPV) may be associated with adverse outcomes in patients with myocardial infarction (MI). We examined the association between MPV and the risk of death and adverse cardiovascular outcomes in patients with MI.


METHODS
We studied consecutive patients with MI admitted to a tertiary-care hospital during a period of 1 year. MPV was measured at admission and at third month. Patients were followed up for 1-year primary composite outcome of cardiovascular death, stroke, fatal or non-fatal MI and cardiac failure. Patients were classified according to tertile of baseline MPV.


RESULTS
A total of 1206 patients with MI, including 934 men (77.4%) and 272 women (22.6%) were studied. The mean age of the study population was 56 years. At 1-year follow-up, 292 (28.57%) primary outcome occurred: cardiovascular mortality 78 (7.6%), fatal or non-fatal MI 153 (15.0%), stroke 30 (2.9%) and cardiac failure 128 (12.52%). Patients with the highest tertile MPV had higher primary outcome as compared with those with MPV in the lowest tertile (adjusted OR=2.31; 95% CI 1.60 to 3.35; p<0.001). Total mortality was also more in high-MPV group (adjusted OR 2.62; 95% CI 1.47 to 4.70; p<0.001). There were no significant changes in mean MPV values at admission from those at third month interval (9.15, (SD 0.99) vs 9.19 (SD 0.94); p=0.2).


CONCLUSIONS
Elevated MPV was associated with worse outcome in patients with acute MI. Elevated MPV in these patients may be due to inherently large platelets.


BACKGROUND
http://ctri.nic.in/Clinicaltrials/rmaindet.php?trialid=5485&EncHid=98036.61144&modid=1&compid=19; CTRI/2012/12/003222.
Department of Cardiology , Kannur Medical College , Anjarakandy, Kerala , India.
Mangalachulli Pottammal
MP
Ranjith
Department of Neurology, SN Mission Hospital , Varkala, Kerala , India.
Rajendran
R
DivyaRaj
Department of Cardiology , Government Medical College , Kozhikode, Kerala , India.
Dolly
D
Mathew
Department of Community Medicine , Government Medical College , Kozhikode, Kerala , India.
Biju
B
George
Department of Cardiology , Government Medical College , Kozhikode, Kerala , India.
Mangalath Narayanan
MN
Krishnan