Comparison of prognostic significance of mean platelet volume/platelet count with GRACE for long-term prognosis in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

Background: Mean platelet volume to platelet count ratio (MPV/P ratio) has been demonstrated to be a predictor of adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aimed to assess whether MPV/P ratio is a useful marker to predict long-term prognosis in NSTEMI patients undergoing PCI. Moreover, the prognostic accuracy of MPV/P ratio was compared with MPV and GRACE score. Methods: In a retrospective cohort study, according to the baseline MPV/P values, 887 consecutive NSTEMI patients undergoing PCI were divided into two groups: the high MPV/P group (n = 296, MPV/P >= 0.054) and the low MPV/P group (n = 591, MPV/P < 0.054). Clinical endpoints were all-cause mortality and all-cause mortality/nonfatal reinfarction. Results: Multivariate analysis showed that high MPV/P was an independent predictor of all-cause mortality [HRs: 1.973, 95% CI: 1.528-2.549, P < 0.001], and all-cause mortality/nonfatal myocardial reinfarction [HRs: 1.289, 95% CI: 1.181-1.408, P < 0.001]. MPV/P ratio has good accuracy for predicting clinical endpoints. The discriminatory performance of MPV/P ratio was similar to GRACE score but better than MPV (for all-cause mortality: MPV/P vs. GRACE: z = 0.205, p = 0.837; MPV/P vs. MPV: z = 2.677, p = 0.008; GRACE vs. MPV: z = 3.017, p = 0.003; for all-cause mortality/nonfatal myocardial: MPV/P vs. GRACE: z = 1.098, p = 0.272; MPV/P vs. MPV: z = 4.026, p < 0.001; GRACE vs. MPV: z = 4.962, p < 0.001). Conclusions: MPV/P ratio was similar to GRACE score but better than MPV for predicting all-cause mortality and all-cause mortality/nonfatal myocardial reinfarction in NSTEMI patients undergoing PCI. However, MPV/P ratio is easier to calculate than GRACE score. (C) 2016 Elsevier Ireland Ltd. All rights reserved.