Prognostic value of rising mean platelet volume during hospitalization in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

Abstract

BackgroundThe prognostic significance of changes in mean platelet volume (MPV) during hospitalization in ST segment elevation myocardial infarction (STEMI) patients underwent primary percutaneous coronary intervention (pPCI) has not been previously evaluated. The aim of this study was to determine the association of in-hospital changes in MPV and mortality in these patients.MethodsFour hundred eighty consecutive STEMI patients were enrolled in this retrospective study. The patients were grouped as survivors (n=370) or non-survivors (n=110). MPV at admission, and at 48-72h was evaluated. Change in MPV (MPV at 48-72h minus MPV on admission) was defined as MPV.ResultsAt follow-up, long-term mortality was 23%. The non-survivors had a high MPV than survivors (0.37 (-0.1-0.89) vs 0.79 (0.30-1.40) fL, p<0.001). A high MPV was an independent predictor of all cause mortality ((HR: 1.301 [1.070-1.582], p=0.008). Morever, for long-term mortality, the AUC of a multivariable model that included age, LVEF, Killip class, and history of stroke/TIA was 0.781 (95% CI:0.731-0.832, p<0.001). When MPV was added to a multivariable model, the AUC was 0.800 (95% CI: 0.750-0.848, z=2.256, difference p=0.0241, Fig. 1). Also, the addition of MPV to a multivariable model was associated with a significant net reclassification improvement estimated at 24.5% (p=0.027) and an integrated discrimination improvement of 0.014 (p=0.0198).ConclusionsRising MPV during hospitalization in STEMI patients treated with pPCI was associated with long-term mortality.