| Objective The aim of this study is to discuss the relationship between the mean platelet volume and the severity of coronary artery disease,the ability of mean platelet volume to predict the severity of coronary artery disease and the surgical options,by comparing the value of mean platelet volume of patients with different severity of coronary artery disease.Methods According to inclusion crteria and exclusion crteria,167 patients with left main lesion underwent coronary angiography in Tianjin Chest Hospital were selected from January 2014 to January 2015,we selected 80 patients in control group who may be suffering from coronary heart disease with chest tightness or chest pain and eliminate the diagnosis of coronary heart disease towards performing coronary angiography.Examination data of patients for the first time were collected including total cholesterol 、 low-density lipoprotein cholesterol 、 high-density lipoprotein cholesterol、triglycerides、creatinine、homocysteine、hypersensitive c-reactive protein、mean platelet volume 。① Clinical baseline datas were compared between left main lesion group and normal control group;②Incorporating all of the patients with left main lesion according to the lesion counts:Left main lesion combined single vessel disease(n=24)、Left main lesion combined double vessels disease(n=45)、Left main lesion combined triple vessels disease(n=98)。Comparing assay indexs of these groups。A simple linear correlation analysis was used to estimate the relationship of Syntax score and mean platelet volume; Whether mean platelet volume and other knowed associated factors to coronary heart disease(including age,sex,hypertension,diabetes,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglycerides) influenced the occurrence of left main lesion combined triple vessels or not was analyzed by Unconditioned binary Logistic regression analysis.Receiver operating characteristic curves(ROC curves) was used to discuss the diagnostic effectiveness of left main lesion combined triple vessel disease by mean platelet volume. ③ Incorporating all of the patients according to the Syntax score:the low Syntax score group(1-22 points,n=47);the median Syntax score group(23-32 points,n=71);the high Syhtax score group(more than 32 points,n=49)。Comparing assay indexs of these groups。Whether mean platelet volume and other knowed associated factors to coronary heart disease influenced the occurrence of more than 32 points of the Syntax score or not was analyzed by Unconditioned binary Logistic regression analysis.Receiver operating characteristic curves(ROC curves) was used to discuss the diagnostic effectiveness of more than 32 points of the Syntax score by mean platelet volume.Results All patients(247 cases)average age was 61.88±8.97,including 136 cases of men(55.06%),111 cases of women(44.94%)。A simple linear correlation analysis showed that mean platelet volume of patients with coronary heart disease had a positive correlation with Syntax score( P < 0.01, r=0.673, regression equation :Y=4.745+0.162X)。①All of the assay indexs of left main lesion combined single vessel disease group、left main lesion combined double vessels disease group and left main lesion combined triple vessels disease group had no significant difference,the results had no statistical difference(P>0.05),but mean platelet volume of the three groups had significant difference,the results had statistical difference(7.23±1.51 vs8.49±1.52 vs 9.92±1.99,P<0.01)。Using LSD-t to compare mean platelet volume and Syntax score of the three groups,we found that mean platelet volume and Syntax score of left main lesion combined triple vessels disease group had a significantly higher level than the other two groups,and mean platelet volume and Syntax score of left main lesion combined double vessels disease group had a significantly higher level than left main lesion combined single vessel disease group( 9.92 ± 1.99 vs8.49±1.52 vs 7.23±1.51,P<0.01;15.17±3.93 vs 23.72±5.18 vs 31.57±5.22,P<0.01)。Unconditioned binary Logistic regression analysis showed that mean platelet volume and hypertension influenced the occurrence of left main lesion combined triple vessels disease(hypertension:P=0.038,OR=0.432,95%CI 0.196-0.954;mean platelet volume:P=0.000,OR=1.991,95%CI 1.559-2.543)。The degree of accuracy of predicting the occurrence of left main lesion combined triple vessels disease was arised from 50% to 70% after introducing the two independent viariables(hypertension and mean platelet volume);The area under the receiver operating characteristic curve( ROC curve) for mean platelet volume in predicting left main lesion combined triple vessels disease was 0.81(P<0.05),95% confidence interval was 0.743-0.878,the best cut-off value was 9.55 fl,the sensitivity was 71.4% and the specificity was 87%。②All of the assay indexs of the low Syntax score group、the median Syntax score group 、 the high Syntax score group had no significant difference,the results had no statistical difference(P>0.05),but mean platelet volume of the three groups had significant difference, the results had statistical difference(P<0.01)。Using LSD-t to compare mean platelet volume of the three groups, we found that mean platelet volume of the high Syntax score group had a significantly higher level than the other two groups,and mean platelet volume of the median Syntax score group had a significantly higher level than the low Syntax score group(10.37±1.34 vs 9.52±1.47 vs 7.39±1.38,P<0.01)。Unconditioned binary Logistic regression analysis showed that mean platelet volume influenced the occurrence of more than 32 points of Syntax score(P=0.000,OR=2.065,95%CI1.551-2.750)。The area under the receiver operating characteristic curve(ROC curve)for mean platelet volume in predicting more than 32 points of Syntax score was 0.78(P<0.05),95% confidence interval was 0.706-0.855,the best cut-off value was9.85 fl,the sensitivity was 73.5% and the specificity was 69.5%。Conclusion① Mean platelet volume of patients with coronary heart disease had a positive correlation with Syntax score。② Mean platelet volume may predict whether a patients with left main lesion disease has three vessels disease or not。③ Mean platelet volume may predict whehter Syntax score of patients with coronary heart disease is more than 32 points, and present useful information in selecting surgical method(PCI or CABG)。... |
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