Relation Of Platelet Parameters With Incident Cardiovascular Disease:The Dongfeng-Tongji Cohort Study

Part 1 Correlation of platelet parameters with major cardiovascular disease risk factorsObjective: Platelet count(PLT),mean platelet volume(MPV)and platelet distribution width(PDW)are parameters reflecting the amount and size distribution of platelets and are susceptible to a range of factors.This study aimed to explore the correlation between platelet parameters and major cardiovascular disease(CVD)risk factors in the middle-aged and older Chinese populations of the Dongfeng-Tongji(DFTJ)cohort.Methods: In the DFTJ cohort,we included 31751 participants who were free of coronary heart disease(CHD),stroke,cancer,severely abnormal electrocardiogram at the time of baseline.After dealing with the missing or extreme data of these platelet parameters,26492,25591,and 25180 participants were included for the analysis of the correlation between PLT,MPV,PDW and major CVD risk factors.Results: PLT was negatively correlated with age(r=-0.167,P<0.01),and positively correlated with BMI(r=0.016,P<0.05),waist circumference(r=0.014,P<0.05),systolic blood pressure(r=0.020,P<0.01),diastolic blood pressure(r=0.070,P<0.01),total cholesterol(r=0.168,P<0.01),triglyceride(r=0.100,P<0.01),low density lipoprotein cholesterol(r=0.147,P<0.01).MPV was negatively correlated with age(r=-0.047,P<0.01),BMI(r=-0.021,P<0.01),waist circumference(r=-0.021,P<0.01),systolic blood pressure(r=-0.014,P<0.05),diastolic blood pressure(r=-0.037,P<0.01),fasting glucose(r=-0.083,P<0.01),total cholesterol(r=-0.082,P<0.01),low density lipoprotein cholesterol(r=-0.014,P<0.05),and positively correlated with high density lipoprotein cholesterol(r=0.044,P<0.01).PDW was negatively correlated with waist circumference(r=-0.082,P<0.01),systolic blood pressure(r=-0.021,P<0.01),diastolic blood pressure(r=-0.120,P<0.01),low density lipoprotein cholesterol(r=-0.027,P<0.01),and positively correlated with age(r=0.035,P<0.01),BMI(r=0.012,P<0.05),fasting glucose(r=0.163,P<0.01),total cholesterol(r=0.042,P<0.01),high density lipoprotein cholesterol(r=0.023,P<0.01).Conclusions: Age was negatively correlated with PLT and MPV,and positively correlated with PDW;BMI and total cholesterol were negatively correlated with MPV,and positively correlated with PLT and PDW;waist circumference,systolic blood pressure,diastolic blood pressure and low density lipoprotein cholesterol were negatively correlated with MPV and PDW,and positively correlated with PLT.Part 2 Relation of platelet parameters with incident cardiovascular disease: the Dongfeng-Tongji cohort studyObjective: PLT,MPV and PDW have been reported to be related to cardiovascular events.However,prospective studies on the relations of these platelet parameters with incident CVD are limited.This study aimed to investigate the above-mentioned prospective relations in the middle-aged and older Chinese populations based on the DFTJ cohort.Methods: In the DFTJ cohort,we included 31751 participants who were free of CHD,stroke,cancer,severely abnormal electrocardiogram at the time of baseline.Follow-up to 31 st December 2016,we identified 5683 incident CVD cases,including 4423 CHD and 1260 stroke cases.Cox proportional hazard models were used to estimate the hazard ratios(HR)and 95% confidence intervals(CI)for the relations between platelet parameters and incident CVD.Results: Compared with participants with 146 109/L ≤ PLT ≤ 233 109/L,the adjusted HR(95% CI)of those with PLT < 146 10E9/L was 0.80(0.68-0.95)for incident stroke.Compared with participants with 7.3 fl ≤ MPV ≤ 10.3 fl,the adjusted HRs(95% CIs)of those with MPV < 7.3 fl were 0.81(0.75-0.88),0.80(0.73-0.88)and 0.84(0.71-1.00)for incident CVD,CHD and stroke,respectively.Compared with participants with 13.2 % ≤ PDW ≤ 18.1 %,the adjusted HRs(95% CIs)of those with PDW < 13.2 % were 0.80(0.73-0.87)and 0.78(0.70-0.86)for incident CVD and CHD,respectively.Conclusions: This study mainly found that lower levels of PLT and MPV were significantly related to lower risk of stroke,while lower levels of MPV and PDW were significantly related to lower risks of CVD and CHD in the middle-aged and older Chinese populations.