Journal
CARDIOLOGY JOURNAL
Volume 20, Issue 5, Pages 491-498Publisher
VIA MEDICA
DOI: 10.5603/CJ.2013.0134
Keywords
platelets; prognosis; myocardial infarction
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Background: Mean platelet volume (MPV) is a strong predictor of impaired angiographic reperfusion and 6-month mortality in ST-elevation myocardial infarction (MI) treated with primary percutaneous coronary intervention (PCI). No data is available for other platelet volume indices: platelet distribution width (PDW) and platelet large cell ratio (P-LCR). The aim was to assess the impact of 3 platelet volume indices on long-term prognosis in patients treated with primary PCI in acute MI. Methods: This prospective study enrolled 538 patients who underwent primary PCI in acute MI. Admission blood samples were measured for MPV, PDW, and P-LCR. The patients were followed-up a mean period of 26 +/- 11 months with regard to cardiac death, non-fatal reinfarction, re-PCI or coronary artery bypass grafting. Results: Kaplan-Meier survival analysis showed a significantly higher 26-month mortality rate in patients with high MPV (>= 11.7 fL) than in those with low MPV (< 11.7 fL) (14.6% vs. 5.5%, p = 0.0008). Similar findings were related to high P-LCR (>= 38.1%) vs. low P-LCR (< 38.1%) -mortality 13.8% vs. 5.8%, p = 0.0025. Higher PDW values (>= 16 fL) correlated with higher mortality rate as compared to PDW < 16 fL (17.4% vs. 6.3%, p = 0.0012). PDW was found to be an independent prognostic factor for cardiac mortality and composite endpoint. Conclusions: Mean platelet volume, platelet distribution width and platelet large cell ratio measured on admission are strong, independent prognostic factors in PCI-treated acute MI.
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