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Mean platelet volume and the risk of periprocedural myocardial infarction in patients undergoing coronary angioplasty

  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Monica Verdoia
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, C.so Mazzini, 18, Eastern Piedmont University, Novara 28100, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Cyril Camaro
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Department of Cardiology, UMC St Radboud, Nijmegen, The Netherlands
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Lucia Barbieri
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, C.so Mazzini, 18, Eastern Piedmont University, Novara 28100, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Alon Schaffer
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, C.so Mazzini, 18, Eastern Piedmont University, Novara 28100, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Paolo Marino
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, C.so Mazzini, 18, Eastern Piedmont University, Novara 28100, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Giorgio Bellomo
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Clinical Chemistry, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, Eastern Piedmont University, Novara, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Harry Suryapranata
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Department of Cardiology, UMC St Radboud, Nijmegen, The Netherlands
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Giuseppe De Luca
    Correspondence
    Corresponding author. Tel.: +39 0321 3733141; fax: +39 0321 3733407.
    Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).
    Affiliations
    Division of Cardiology, Azienda Ospedaliera-Universitaria “Maggiore della Carità”, C.so Mazzini, 18, Eastern Piedmont University, Novara 28100, Italy
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  • Author Footnotes
    1 On behalf of the Novara Atherosclerosis Study Group (NAS).

      Abstract

      Background

      Periprocedural myocardial infarction (PMI) represents a relatively common complication of percutaneous coronary intervention (PCI). Mean platelet volume (MPV) has been proposed as a marker for platelet activation, as larger sized platelets have been associated with higher pro-thrombotic risk. Therefore, aim of the current study was to evaluate whether MPV is associated with increased risk of PMI after PCI.

      Methods

      We included 1056 consecutive patients undergoing PCI. We measured myonecrosis biomarkers at intervals from 6 to 48 h after PCI. Periprocedural myonecrosis was defined for troponin I increase by 3 times the ULN or by 50% if elevated at the time of the procedure. PMI was defined as CK-MB increase by 3 times the ULN or 50% if elevated at the time of the procedure.

      Results

      We grouped patients according to tertiles values of MPV (<10.4 fl; 10.5–11.3 fl; >11.4 fl). High MPV was associated with diabetes (p = 0.025) and higher prevalence of cerebrovascular events (p = 0.005). MPV significantly related with haemoglobin levels (p < 0.001), but inversely to platelet count (p < 0.001) and higher presence of thrombus (p = 0.03). Larger sized platelets did not increase risk of periprocedural myonecrosis (p = 0.91; OR[95% CI] = 1.04[0.90–1.2], p = 0.64) or PMI (p = 0.09; OR[95%IC] = 1.13[0.93–1.37]; p = 0.20). Subgroup analysis confirmed no impact of MPV on periprocedural MI also in high-risk subsets of patients, such as those with ACS at presentation (OR[95%CI] = 1.09 [0.87–1.38]; p = 0.44), diabetes (OR[95% CI] = 1.02[0.71–1.47], p = 0.91), female gender (OR [95% CI] = 1.15 [0.78–1.71], p = 0.48), elderly patients (age ≥ 75 years) (OR[95%CI] = 1.21[0.87–1.69], p = 0.25) or with renal failure (OR[95%CI] = 1.55[0.91–2.61], p = 0.1).

      Conclusions

      This study demonstrates that MPV does not predict the risk of PMI in patients undergoing PCI.

      Highlights

      ▶ 1056 patients undergoing elective PCI were included. ▶ Patients were grouped according to tertiles values of Mean Platelet Volume. ▶ Platelet size did not increase risk of Periprocedural Myocardial Infarction. ▶ We confirmed no impact of MPV on PMI even in high-risk subgroups of patients.

      Keywords

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