Platelet Distribution Width Is Associated With Thrombolysis Outcomes And Short-term Prognosis In ST-segment Elevation Myocardial Infarction

Objective: We investigated 2 hypotheses:(1)A relationship between Platelet distribution width(PDW)and short-term prognosis in patients with ST-segment elevation myocardial infarction(STEMI);(2)A relationship between PDW and thrombolysis outcomes in patients with STEMI.Methods: In this retrospective study,A total of 862 patients with STEMI were enrolled in the First Hospital of Lanzhou University from January 2016 to January 2019.233 patients were treated with thrombolysis therapy before the hospital in these people.According to the results of emergency coronary angiography after thrombolysis,the patients were divided into successful thrombolysis group and thrombolysis failure group.The baseline data of the two groups were compared,and the multivariate logistic regression analysis was performed according to the results.Draw the ROC curve.All 862 patients were divided into three groups of PDW as baseline.Data comparison,multivariate logistic regression analysis was performed with the major cardiovascular adverse events(MACE events)in the hospital as the dependent variable,and the ROC curve was drawn.Results: Heart rate,blood glucose,platelet distribution width,platelet mean volume(MPV),large platelet ratio(P-LCR)and GRACE scores in the thrombolysis failure group were higher than those in the successful thrombolysis group,and the use rate of selective plasminogen activator was low.The PDW(OR=1.203,95% CI=1.022-1.417,P=0.026),blood glucose(OR=1.111,95% CI=1.004-1.229,P=0.041)were independent predictors for thrombolysis failure.When the PDW cut-off value was 17.75 fL,the area under the curve(AUC)of predicted thrombolysis failure was 0.660(P < 0.001).Platelet,MPV,P-LCR,triglyceride,creatinine,blood glucose,uric acid,GRACE score,diabetes,and in-hospital MACE events were significantly different as the platelet distribution width increased.And PDW(OR=1.171,95% CI=1.031-1.331,P=0.015),white blood cells(OR=1.080 95%CI=1.003-1.164,P=0.042),GRACE score(OR=1.042,95%CI=1.031)-1.054,P < 0.001)and diabetes(OR = 2.574,95% CI = 1.235-5.364,P = 0.012)were independent predictors for in-hospital MACE events.When the PDW cut-off value was 17.75 fL,the AUC of the in-hospital MACE event was predicted to be 0.746(P < 0.001).PDW combined with GRACE score predicted AUC of the in-hospital death = 0.836(P < 0.001).Conclusion: PDW is independently associated with thrombolysis failure and in-hospital MACE events in STEMI patients.It has certain predictive value and clinical significance for the thrombolysis outcome and short-term prognosis of acute ST-segment elevation myocardial infarction.