Impact of the mean platelet volume level on clinical outcomes in outpatient patients with pulmonary arterial hypertension

INTRODUCTION: Right heart failure (HF) is main cause of death and rehospitalization in pulmonary arterial hypertension (PAH) patients. The aim of this study was to assess the relationship between mean platelet volume (MPV) with HFrelated hospitalization and mortality in outpatient PAH patients METHODS: We conducted a retrospective cohort study of 86 PAH outpatients who admitted to our special PAH clinic for periodic routine controls between June 2011 and August 2017. According to the receiver-operating characteristic analysis, the optimal cut-off value of MPV to predict HF-related hospitalization was > 8.4 fL. Patients divided to two categories as MPV > 8.4 fL and MPV ≤ 8.4 fL groups. Potential predictors were evaluated in univariate and multivariate Cox regression analysis. RESULTS: The mean age of patients was 50.8±11.6 years. The mean follow-up was 27±13 months. HF-related hospitalization was found markedly higher in MPV > 8.4 fL group than MPV ≤ 8.4 fL group (73.0% vs. 12.2%, p 8.4 fL and BMI were associated with HF-related hospitalization in outpatient PAH patients (p=0.009 and p=0.047, respectively). In multivariate analysis, MPV > 8.4 fL was found a strong independent predictor of HF-related hospitalization in outpatient PAH patients (p=0.001, hazard ratio 7.639, 95% CI 2.414-24.178). DISCUSSION AND CONCLUSION: The relationship between increased MPV level and HF-related hospitalization in outpatient PAH patients may be useful to identfy high-risk patients in follow-up.

Ayaktan pulmoner arteryel hipertansiyon hastalarında ortalama trombosit hacmi düzeyinin klinik sonlanımlar üzerine etkisi

GİRİŞ ve AMAÇ: Sağ kalp yetersizliği (KY) pulmoner arteryel hipertansiyon (PAH) hastalarında hastaneye yatışların ve ölümün başlıca nedenidir. Bu çalışmanın amacı; ayaktan PAH hastalarında Ortalama Trombosit Hacmi (OTH) ile KY nedenli hastaneye yatış ve mortalite arasındaki ilişkiyi değerlendirmekti. YÖNTEM ve GEREÇLER: Haziran 2011 ve Ağustos 2017 tarihleri arasında periyodik rutin kontolleri için spesifik PAH polikliniğimize başvurmuş 86 ayaktan PAH hastasından oluşan bir geriye dönük çalışma planladık. ROC analizine göre KY nedenli hastaneye yatışı öngördüren optimal OTH değeri > 8.4 fL olarak bulundu. Hastalar OTH > 8.4 fL ve OTH ≤ 8.4 fL olarak iki gruba ayrıldı. Olası öngördürücüler tek değişkenli ve çok değişkenli Cox regresyon analizi ile değerlendirildi. BULGULAR: Hastaların yaş ortalaması 50.8±11.6 idi. Ortalama takip süresi 27±13 aydı. OTH > 8.4 fL grubunda OTH ≤ 8.4 fL grubuna göre KY nedenli hastaneye yatış belirgin olarak daha fazlaydı (%73.0’e %12.2, p 8.4 fL olması ve vücut kitle indeksi ayaktan PAH hastalarında KY nedenli hastaneye yatış ile ilişkiliydi (p=0.009 ve p= 0.047, sırasıyla). Çok değişkenli analizde, OTH > 8.4 fL olması ayaktan PAH hastalarında KY nedenli hastaneye yatışların bağımsız güçlü bir öngördürüsü olarak bulundu (p=0.001, hazard ratio 7.639, 95% CI 2.414-24.178). TARTIŞMA ve SONUÇ: Ayaktan PAH hastalarında artmış OTH düzeyi ile KY nedenli hastaneye yatış arasındaki ilişki takiplerde yüksek riskli hastaları belirlemede kullanışlı olabilir.

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  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
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