Role of MPV and Platelet/MPV Ratio in The Diagnosis of Cardiac Dilemma; Cardiac or Non-Cardiac Chest Pain, and Severity of Acute Coronary Syndrome

ABSTRACT INTRODUCTION: We aimed to investigate effectiveness of mean platelets volume (MPV) and platelet/MPV ratio as an independent marker on mortality for prediction of critical vascular stenosis in the differential diagnosis of acute coronary syndrome and cardiac/non-cardiac chest pain in patients presenting to the emergency department. METHODS: Retrospective observational study included patients of 45 years of age and above presented to the ED with chest pain. Patients were divided into groups with cardiac/non-cardiac chest pain. MPV, platelets/MPV ratio, coronary anjıography results, inhospital and 1-month hospital mortality were recorded RESULTS: A total of 753 patients; Cardiac pathology was determined in 282 (37.46%). The mean age was determined as 60.1 years and 59% were male. A statistically significant difference was detected between cardiac and non-cardiac patients with regard to platelet, MPV and plt/MPV values (p=0.005, p

Kardiyak Göğüs Ağrısı ve Akut Koroner Sendrom Şiddeti Ayırıcı Tanısında MPV ve Platenet/MPV Oranının Rolü

ÖZ GİRİŞ ve AMAÇ: Acil servise başvuran hastalarda akut koroner sendrom ve kardiyak / kardiyak olmayan göğüs ağrısının ayırıcı tanısı ile kritik vaskuler stenozun öngörülmesinde mortalite üzerine bağımsız bir belirteç olarak mean platelet volum (MPV) ve trombosit / MPV oranının etkinliğini araştırmak. YÖNTEM ve GEREÇLER: Retrospektif gözlemsel çalışmaya göğüs ağrısı ile acil servise başvuran 45 yaş ve üstü hastalar dahil edildi. Hastalar kardiyak / kardiyak olmayan göğüs ağrısı olarak gruplara ayrıldı. MPV, trombosit/ MPV oranı, koroner anjiyografi sonuçları, hastane içi ve 1 aylık hastane mortalitesi kaydedildi. BULGULAR: Çalışmaya katılan 753 hastanın %37,46'sında kardiyak patoloji tespit edildi. Tüm hastaların yaş ortalaması 60,1 ve tüm hastaların % 59'u erkekti. Kardiyak ve kardiyak olmayan hastalar arasında trombosit, Mean platelet volum (MPV) ve trombosit / MPV değerleri açısından istatistiksel olarak anlamlı bir fark saptanmıştır (sırasıyla p = 0.005, p

___

1. Wang Trip MD, Cats VK, Van Capelle FJL, Vreeken J. Platelet hyperreactivity and prognosis in survivors of myocardial infarction. New Engl J Med 1990; 322:1549–54.

2. Corash L, Tan H, Grolnick HR. Heterogeneity of human whole blood platelet subpopulations. Relationship between buoyant density, cell volume and ultrastructure. Blood 1977; 49:71–87

3. Thompson CB, Eaton KA, Princiotta SM, Rushin CA, Valeri CR. Size-dependent platelet subpopulation: relationship of platelet volume to ultrastructure, enzymatic activity and function. Br J Haematol 1982; 50:509–20

4. Jneid H. The 2012 ACCF/AHA Focused Update of the Unstable Angina/Non-ST-Elevation Myocardial Infarction (UA/NSTEMI) Guideline: A critical appraisal. Methodist Debakey Cardiovasc J 2012; 8:26-30.

5. Hsin C, Wei-Lung C, Chien-Cheng H, et all. Diagnostic performance of mean platelet volume for patients with acute coronary syndrome visiting an emergency department with acute chest pain: the Chinese scenario ; Emerg Med J 2011;28:569-574. doi:10.1136/emj.2010.093096

6. Herrmann J, Von Birgelen C, Haude M. et al.Prognostic implication of cardiac troponin T increase following stent implantation. Heart. 2002 Jun; 87(6): 549–553.

7. Mehta SR, Cannon CP, Fox KA. et all. Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials. JAMA 2005;293:2908-2917

8. Khaspekova SG, Ziuriaev IT, Lakushkin VV, et all. Mean Platelet Volume: Interactions with platelet aggregation activity and glycoprotein IIb-IIa and expression levels. Biomed Khim. 2014 JJan-Feb; 60 (1): 94-108

9. Schull MJ, Vermeulen MJ, Stukel TA. The risk of missed diagnosis of acute myocardial infarction associated with emergency department volume. Ann Emerg Med. 2006 Dec;48(6):647-55. Epub 2006 Jun 14.

10. Taskesen T, Sekhon H, Wroblewski I. et all. Usefulness of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients with Non-ST Elevation Acute Coronary Syndromes, The American Journal of Cardiology (2016), doi: 10.1016/j.amjcard.2016.09.042

11. Cameron HP, Ibbotson RM, Carson PHM. Platelet size in myocardial infarction. BMJ 1983; 287:449–51.

12. Pizzuli L,Yang A, Martin JF, Luderitz B. Changes in plate- let size and count in unstable angina compared to stable or non-cardiac chest pain. Eur Heart J 1998;19:80–4

13. Lippi G, Filippozzi L, Salvagno GL. et all. Increased mean platelet volume in patients with acute coronary syndromes. Arch Pathol Lab Med 2009;133:1441–3

14. Yilmaz MB, Cihan G, Guray Y, et al. Role of mean platelet volume in triaging acute coronary syndromes. J Thromb Thrombolysis. 2008 Aug;26(1):49-54. Epub 2007 Aug 20

15. De Lucaa G, Santagostino M, Gabrio Secco G. et all. Mean platelet volume and the extent of coronary artery disease: Results from a large prospective study. Atherosclerosis 206 (2009) 292– 297

16. Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J 2001; 22: 1561–71

17. Souza Santos I, Carvalho Goulart A, Martins Brandao R, et all. One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study. Arq Bras Cardiol. 2015 Jul; 105 (1): 53-64

18. Chu S.G, Becker R.C, Berger P.B. et all. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. Journal of Thrombosis and Haemostasis, 2009 ;8: 148–156

19. Tekbas E, Kara A.F, Arıturk Z. et all. Mean platelet volume in predicting short- and long-term morbidity and mortality in patients with or without ST-segment elevation myocardial infarction. Scandinavian Journal of Clinical & Laboratory Investigation, 2011; 71: 613–619

20. Pereg D, Berlin T, Mosseri M. Mean platelet volume on admission correlates with impaired response to thrombolysis in patients with ST-elevation myocardial infarction. Platelets, March 2010; 21(2): 117–121

21. Kaushansky K. Thrombopoietin: the primary regulator of platelet production. Blood 1995;86:419– 31

22. Yang A, Pizzulli L, Luderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris. Thromb Res 2006;117:371–7.

23. Azab B, Torbey E, Singh J. et all. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets, December 2011; 22(8): 557–566 DOI: 10.3109/09537104.2011.584086.
Kocaeli Tıp Dergisi-Cover
  • ISSN: 2147-0758
  • Yayın Aralığı: 3
  • Başlangıç: 2012
  • Yayıncı: -
Sayıdaki Diğer Makaleler

Girişimsel Kardiyologlar Arasında Atriyal Fibrilasyon Farkındalık Anketi Değerlendirmesi

Cengiz BURAK, Muhammed SÜLEYMANOĞLU, Serhat HAYME, Erkan BAYSAL, İlyas KAYA, Bernas ALTINTAŞ, Serhat GÜNLÜ

Kadın Hastalarda Koroner Yavaş Akımın Klinik Blirleyicileri

Zarema KARBEN, Alper SERCELİK, Fikret BESNİLİ

Kardiyak Göğüs Ağrısı ve Akut Koroner Sendrom Şiddeti Ayırıcı Tanısında MPV ve Platenet/MPV Oranının Rolü

Onur KARAKAYALI, Serkan YİLMAZ, Serdar BOZYEL, Anıl KARAKAYALI

Re-Emergence of A Splenic Artery Pseudoaneurysm Following Rupture Presenting as Syncope: Management with Transarterial Embolization

Fatih UZUNKAYA, Ayşegül İdil SOYLU, Kağan KARABULUT, Mehmet Selim NURAL

Q Ateşi’nin Yeterince Farkında Mıyız? Tek Merkez Deneyimi

Fatma SIRMATEL, Hasan Tahsin G, Hayrettin AKDENİZ, Şeyma KARABÖRK

Clinical and Demographic Profile of Patients with Active Epilepsy: Experience From a Tertiary Care Hospital in Turkey

Şehnaz BAŞARAN, Muhammed nur ÖĞÜN

The Relationship Between Coronary Artery Ectasia and Coronary Collateral Circulation in Patients with Chronic Total Occlusion

Bernas ALTINTAŞ, Halil AKIN

Right Ventricular Diastolic Functions in Pediatric Patients with İsolated Pulmonary Valve Regurgitation

Mehtap AKBALIK KARA, Pelin AYYILDIZ, Metin SUNGUR, Nazlıhan GÜNAL, Mehmet kemal BAYSAL

İntermittan Ekzotropyalı Çocuklarda Okülo-Motor Egzersizlerin Etkisinin Araştırılması

Işıl KUTLUTÜRK KARAGÖZ, Gülay ARAS BAYRAM, Betül İlkay SEZGİN AKÇAY, Candan ALGUN

Yumuşak Kontak Lens Bakımında Türkiye'deki Hastaların Tutumları ve Uyum Düzeyleri

Hasan ALTINKAYNAK, Hüseyin DÜNDAR, Can KOCASARAÇ, Abdulvahit DEMİR