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Mean Platelet Volume as a predictor of in-hospital complications in Acute Coronary Syndromes
Session:
Painel 7 -Doença Coronária 5
Speaker:
Maria Inês Fiúza Pires
Congress:
CPC 2020
Topic:
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme:
13. Acute Coronary Syndromes
Subtheme:
13.2 Acute Coronary Syndromes – Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
Inês Pires; João Miguel Santos; Maria Luisa Gonçalves; Joana Laranjeira Correia; Hugo Da Silva Antunes; José Costa Cabral; Inês Almeida
Abstract
<p>Background: Mean Platelet Volume (MPV) is an indicator of platelet activation, with higher volumes being associated with increased prothrombotic potential. Some studies have related increased MPV with poor outcomes in acute coronary syndromes (ACS). Global Registry of Acute Coronary Events (GRACE) Score is the most used tool in risk stratification in ACS. This study aims to evaluate MPV as a predictor of in-hospital complications in ACS and compare it with the GRACE Score (Gs).</p> <p>Methods: All patients (P) admitted for ACS in a Cardiology Department for 9 years were included. MPV and Gs were obtained at admission. MPV was considered elevated if superior to its median (8.9fL). Primary outcome was in-hospital complications: death, cardiogenic shock, ventricular arrhythmias, mechanical complications, stroke, bleeding or worsening of renal function. Statistical analysis used Chi-square and Mann-Whitney U tests, logistic regression analysis and receiver operating characteristic (ROC) curves.</p> <p>Results: 1003 P were studied (mean age 67.8±12.7years, 71.2% male). Mean MPV was 9.1±1.1 fL, and 47.8% P had high MPV. Primary outcome occurred in 268 (26.7%) P: 22.7% with low MPV vs. 31.1% with high MPV (p=0.003).</p> <p>Higher MPV was associated with older age (p<0.001); type 2 diabetes mellitus (p=0.017) and previous coronary artery bypass graft (p=0.048). At admission, P with high MPV had lower levels of platelets (p<0.001) and hemoglobin (p=0.004); higher levels of urea (p=0.009) and BNP (p<0.001); lower left ventricle ejection fraction (p=0.02) and higher Gs (p<0.001). There was no difference in antithrombotic therapy or revascularization strategy between the groups.</p> <p>Univariate logistic regression analysis showed that high MPV was a predictor of in-hospital complications (OR 1.537; 95% CI 1.160-2.036; p=0.03). In multivariate analysis, high MPV was a predictor of the primary outcome (OR 1.399; 95% CI 1.034-1.892; p=0.03) independent from Gs>140 or admission levels of platelets and hemoglobin. The addition of high MPV to Gs was superior (AUC 0.582) in the prediction of in-hospital complications than the sole use of either MPV (AUC 0.551, p=0.06) or Gs (AUC 0.561, p=0.03).</p> <p>Conclusions: In this study, MPV was a predictor of in-hospital complications in P with ACS, and was independent of Gs>140 and of hemoglobin and platelets levels at admission. The combination of MPV with Gs allowed better risk prediction, so in the future this readily available value might be used in risk stratification.</p>
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