Prognostic Value Of Mean Platelet Volume On Major Adverse Cardiovascular Events In Patients With ST-elevated Myocardial Infarction After Percutaneous Coronary Intervention

Objectives: To investigate the relationship of mean plateletvolume(MPV) with1-year major adverse cardiovascular events(MACE) inpatients with ST-elevated myocardial infarction (STEMI) afterpercutaneous coronary intervention(PCI) and to explore its value onprognosis.Methods：301patients with acute STEMI live in department ofcardiology,Ningxia People’s hospital from January2011to June2012included in our study. All patients were treated with successfully primaryPCI. We investigated Patients’ demographic information. Patients weredivided into2groups(G) according to their mean platelet volume (A≤9.9fl, n=103; B＞9.9fl, n=198;AB,n=301) which was measured on admission.They were divided into2groups(G) according to their mean platelet volume(C≤9.9fl, n=101; D＞9.9fl, n=200;CD,n=301) which was measured againwithin24hours after PCI. All patients were continuously followed up byusing telephone contact or clinical interview for at least12-months. Alldata were analyzed by SPSS18.0. Descriptive statistics was presented asthe mean±standard deviation（SD）for continuous variables. Comparisonbetween two groups was performed by means of independent samples t test.Categorical variables were compared by the chi-square test. Theindependent effect of variables on prognosis was calculated using Binary logistic regression analysis, and the results are shown as an odds ratio(OR) with95%confidence intervals(CIs).A2-tailed P <0.05was consideredsignificant.Results: A and B groups’ criminal vascular distribution of havesignificant differences (p <0.001). A and B stents length (mm)(56.8±18.7VS65.7±20.8, p <0.001). A and B white blood cells(×109/L)(10.08±1.47VS11.23±2.04, p <0.001). There are significant differences inthe total number of platelets (p=0.009), and the level of triglycerideand total cholesterol (p <0.001).C and D groups’ criminal vasculardistribution have significant difference (p <0.001), the time (hour) fromonset to balloon have a significant difference (p=0.003). C and D stentslength (mm)(56.8±18.7VS65.7±20.8, p <0.001). white blood cells(×109/L)(10.15±1.61VS11.27±2.07, p <0.001). There are significantdifferences in the total number of platelets (p=0.003), and the levelof triglyceride and total cholesterol (p <0.001). MACE rate was higherin B than in A (25.2%vs.13.5%; P=0.019).This difference resulted fromRecurrent-angina (17.6%vs.7.7%; P=0.020) and Re-hospitalization (19.6%vs.9.7%; P=0.026). MACE rate was higher in D than in C (25%vs.13.9%;P=0.026).This difference resulted from Recurrent-angina (17.5%vs.7.9%;P=0.025) and Re-hospitalization (19.5%vs.9.9%; P=0.033). In Binarylogistic regression analysis, In Binary logistic regression analysis,Preoperative elevated MPV(>9.9fl) was an independent predictor of MACEin patients with STEMI after PCI (OR2.12,95%CL1.03-4.34,p=0.039).Postoperative elevated MPV(>9.9fl) was also an independentpredictor of MACE (OR2.05,95%CL1.00-4.20, p=0.048).Conclusion: Preoperative and postoperative elevated MPV was independently associated with MACE in patients with STEMI after primaryPCI. Moreover, MPV greater than9.9fl was predictive of a1-year MACE.