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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Article info
Publication history
Published online: March 21, 2013
Accepted:
January 9,
2013
Received in revised form:
January 4,
2013
Received:
December 1,
2012
Identification
Copyright
© 2013 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
