| Objective: Mean platelet volume(MPV) and platelet large cell rate(P-LCR) are mainly used to reflect index of platelet volume change in the clinical. As an indicator for the degree of platelet activation, platelet volume change also plays important roles in the processes of acute coronary syndrome(ACS). However, there are limited data on clinical between MPV, P-LCR changes and ACS. The study summarized the recent findings concerning the correlation between alterations in MPV, P-LCR changes and ACS.Methods: A total of 358 patients were enrolled in this study. 273 patients were diagnosed with acute coronary syndrome(unstable angina: n=117 patients; non ST-segment elevation myocardial infarction: n=62 patients; ST-segment elevation myocardial infarction: n=94 patients). Other patients without coronary heart diease were included in control group. Complete blood count, c TNI, CK-MB and BNP were tested immediately after being hospitalized. All patients underwent coronary angiography examination, and then calculated Gensini score as evaluation index of the severity of coronary artery lesions according to the results of coronary angiography. A total of 131 patients who treated by PCI were followed up for 6months. The MPV level were measured again after a month and calculated the MPV decline rate. MPV decline rate(%) =(admission test value- review)/hospital measurement value by 100%, according to the median of MPV drop ratio 7.96%, The patients can be divided into less than 7.96% group and more than 7.96% group.Primary end point was six month incidence of major adverse cardiac events(MACE):cardiovascular death(CV), myocardial infarction(MI), or unplanned target vessel revascularization(TVR). SPSS 19.0 software was used for statistical analysis.Results:1. MPV in patients with ACS(10.03±0.16 fl) were significantly higher than that in control group(9.60±0.84 fl)(P<0.05), P-LCR in patients with ACS(24.57±8.07fl) were significantly higher than that in control group(19.24±6.32fl)(P<0.05). Further more, in ACS group, MPV was significantly increasing from UA subgroup(9.91±1.16fl) to NSTEMI subgroup(11.16±3.12fl)(P<0.05). P-LCR was significantly increasing from UA subgroup(19.38±6.42%) to NSTEMI subgroup(26.42±8.44%)(P<0.05).2. Spearman’s correlation analysis revealed that MPV and P-LCR were correlated positively with Gensini score. Multiariable Logistic regression analysis showed that MPV and P-LCR were risk factors for the onset of ACS.3. With multiple linear stepwise regression analysis, WBC(beta=0.239), N(beta= 0.043), LDL(beta=0.003) were associated with MPV(P<0.05), and apoa1(beta=-10.517), LDL(beta=0.012) were associated with P-LCR(P<0.05).4. During the follow-up period, there were 6 cases MACE incident, including 1case cardiac death, 4 case nonfatal myocardial infarction and 1 case TVR. Incidence of MACE in less than 7.96% group was obviously higher than that of another group,line COX regression analysis showed that average length of stents(P=0.039,OR=0.955), Gensini score(P=0.007, OR=1.008) and MPV decline rate(P=0.049,OR=0.067) were correlated to the MACE in follow up.Conclusion:1. Platelet volume change was associated with disease severity of ACS.2. The change of MPV, P –LCR were positively correlated with Gensini score,which can reflect the severity of coronary artery lesions.3. Follow-up results showed that the incidence of MACE in MPV mild decline group was higher than another group, suggests platelet volume 1 month when changes associated with MACE within six months. |
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