Correlation Between Mean Platelet Volume At Admissiom And MACE In Emergency PCI Patients During Hospitalization

ObjectiveMean platelet volume(MPV)is not only an important index to evaluate platelet function but also a research hotspot in the prediction of cardiovascular events.The purpose of this study was to explore the predictive value of MPV on major adverse cardiovascular events(MACE)in patients with acute myocardial infarction after emergency percutaneous coronary intervention(PCI),so as to provide reference basis for clinical prevention of mace.Methods938 patients with acute myocardial infarction treated in the Department of Cardiology of the first people’s Hospital Affiliated to Suzhou University from January 1,2015 to September 30,2019 were selected as the research objects.Basic clinical data of all patients were collected,including name,age,onset date,hospitalization date,hypertension,diabetes,hyperlipidemia,smoking history,etc.After admission,physical examination,blood routine test,biochemical index test and imaging examination were performed before anti platelet aggregation and other drug treatment,including MPV,platelet count(PLT),creatine kinase isoenzyme(CK-MB),blood glucose level,blood lipid level,liver function,renal function,cardiac function ejection fraction(LVEF),etc.According to whether MACE occurred during hospitalization,patients were divided into MACE group and non-MACE group.The basic clinical data,blood routine test results,related biochemical index levels and imaging indexes ofthe two groups were analyzed by single factor analysis,and a multiple logistic regression model was established to analyze the independent risk factors of mace after PCI in patients with acute myocardial infarction.The receiver operating characteristic curve(ROC)was drawn,the area under the curve(AUC)was calculated,and the predictive value of MPV value on admission for in-hospital mace after PCI in patients with myocardial infarction was evaluated.According to the quartile of MPV,the age,gender,biochemical index level and the incidence of MACE were compared among patients with different MPV.Results(1)In this study,192 of 938 patients with acute myocardial infarction developed MACE after PCI,with an incidence of 20.5%(192 / 938).(2)Univariate analysis showed that MPV,AST,Cr and age in MACE group were significantly higher than those in non-MACE group,while LVEF was significantly lower than that in non-MACE group(P < 0.05).The proportion of women(22.9% vs 16.4%)and hypertension(67.7% vs 55.0%)in MACE group were significantly higher than those in non-MACE group(P < 0.05).(3)Logistic regression analysis showed that MPV(OR=1.332),AST(OR=1.001),age(OR=1.031)and hypertension(OR=1.526)were independent factors affecting MACE(P <0.05).(4)ROC curve analysis showed that the AUC of MPV in predicting MACE after PCI in patients with acute myocardial infarction was 0.641(95% CI: 0.564 ～ 0.719),which had significant predictive value(AUC > 0.5,P = 0.001).(5)The quartiles of MPV(P25,P50 and P75)were 9.10,9.80 and 10.70 respectively.According to the quartiles,they were divided into four groups: MPV < 9.10,9.10 ～ 9.80,9.80 ～ 10.70 and > 10.70.There were significant differences in PLT,AST,malignant arrhythmia and major attack of heart failure among the four groups(P < 0.05).The higher the MPV,the lower the PLT and higher the AST,and the higher the incidence ofmalignant arrhythmia and major attack ofheart failure.ConclusionMPV has high predictive value for MACE in hospital after PCI in patients with emergency myocardial infarction,and can be used as an effective index to predict MACE in patients with emergency PCI during hospitalization.