title: Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention.
abstract: BACKGROUND
  The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied.
  
  
  OBJECTIVE
  The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.
  
  
  METHODS
  On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.
  
  
  RESULTS
  According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401-6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190-7.0225, p = 0.0457).
  
  
  CONCLUSIONS
  Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.
authors.forename: Michał
authors.initials: M
authors.lastname: Kowara
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. kajetan.grodecki@gmail.com.
authors.forename: Kajetan
authors.initials: K
authors.lastname: Grodecki
authors.forename: Zenon
authors.initials: Z
authors.lastname: Huczek
authors.forename: Dominika
authors.initials: D
authors.lastname: Puchta
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Paczwa
authors.forename: Bartosz
authors.initials: B
authors.lastname: Rymuza
authors.forename: Karol
authors.initials: K
authors.lastname: Zbroński
authors.forename: Krzysztof J
authors.initials: KJ
authors.lastname: Filipiak
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D010979:Platelet Function Tests; D011184:Postoperative Period; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis*
keywords: left ventricular ejection fraction; percutaneous coronary intervention; platelet distribution width