Correlation Between Mean Platelet Volume And Severity Of Coronary Artery Disease In Patients With Coronary Heart Disease

Objective:In this report,we investigated the relationship between mean platelet volume(MPV)and severity of coronary artery disease in patients with coronary heart disease.Methods:The study population included 418 patients with coronary heart disease(CHD)confirmed by selective coronary angiography(CAG)in the First Affiliated Hospital of Suzhou University,age from 34 to 89 years old,average age were 62.95±10.60 years old.Among them,317 cases(75.84%)were males,with an average age of 61.88±10.64 years old;101 cases(24.16%)were female,with an average age of 66.30±9.76 years old.All the patients recorded age,sex,height and weight and coculated body mass index.Venous blood was drawn from all subjects within 24 hours of admission.White blood cell(WBC),neutrophil(N),lymphocyte(L),hemoglobin(Hb),platelet count(PLT),MPV and Troponin I(TnI)were drawn.On the morning after admission,fasting venous blood was taken,and we serum creatinine(SCr),total choesterol(TC),high-density lipoproteinchelesterol(HDL-C),and low-density lipoproteinchelesterol(LDL-C),fasting glucose,(FBG),uric acid(UA),high-sensitivity c-reactive protein(Hs-CRP),fibrinogen(FIB).All the subjects were treated with CAG during the period of hospitalization,and SYNTAX score was given according to the results of coronary angiography.According to the clinical symptoms in patients with coronary heart disease can be divided into Stable angina pectoris(SAP)group,Non ST segment elevation elevation acute coronary syndrome(NSTE-ACS)group and st-elevation myocardial infarction(STEMI)group.The MPV differences between the groups were compared and the correlation between MPV and SYNTAX integral was analyzed.According to SYNTAX score,CHD patients were divided into mild coronary artery disease group(SYNTAX score?22)and moderate to severe coronary artery disease group(SYNTAX score>22).MPV differences between the two groups were compared and the correlation between MPV and SYNTAX score was analyzed.Results:1.According to clinical symptoms,ecg and myocardial injury markers,418 patients were divided into SAP group(118 cases),NSTE-ACS group(146 cases)and STEMI group(154 cases),the MPV values of STEMI group(11.00±1.31fl)>NSTE-ACS group(10.58±1.29fl)>SAP group(9.97±1.02fl).There were significant differences among the three groups(P<0.001).MPV values of SAP group and NSTE-ACS group were statistically different(P<0.001),MPV values of SAP group and STEMI group were statistically different(P<0.001),MPV values of NSTE-ACS group and STEMI group were statistically different(P=0.010).There were statistically significant differences among the three groups in gender(P<0.001),smoking(P<0.001),N(P<0.001),L(P<0.001),PLT(P<0.001),SCr(P=0.010),hdl-c(P<0.001),FBG(P=0.049),hs-crp(P<0.001),FIB(P<0.001)and TnI(P<0.001).There was no significant difference in age(P=0.924),hypertension(P=0.098),diabetes mellitus(P=0.387),BMI(P=0.313),Hb(P=0.089),TC(P=0.615),ldl-c(P=0.297)and UA(P=0.180).2.Spearman correlation analysis showed that MPV was positively correlated with SYNTAX score(r=0.391,P<0.001).Spearman correlation analysis showed that MPV was positively correlated with SYNTAX score in NSTE-ACS group and STEMI group(r=0.364,P<0.001,r=0.413,P<0.001),while MPV was not correlated with SYNTAX score in SAP group(P=0.928).3.The severity of coronary artery lesion was divided into mild lesion group(SYNTAX<22)and moderate and severe lesion group(SYNTAX>22)according to SYNTAX score.The MPV of mild lesion group was 10.37±1.27fl and that of moderate and severe lesion group was 11.21±1.16fl.The MPV value in the moderate and severe coronary artery disease group was higher than that in the mild coronary artery disease group,and the difference was statistically significant(Z=-5.748,P<0.001).Multivariate logistic regression analysis showed that MPV was an independent predictor of SYNTAX score greater than 22 points(OR=0.597,95%CI:0.489?0.729,P<0.001).Finally,receiver operating characteristic curve(ROC curve)showed that area under curve was 0.696(95%CI:0.639?0.752,P<0.001).MPV value of 10.25f1 was identified as the best effective cut-point in the SYNTAX score>22(sensibility 78.5%,specificity 52.6%).Conculsions:1.MPV was significantly different in SAP group,NSTE-ACS group and STEMI group,and increased with the aggravation of the disease.2.MPV was positively correlated with SYNTAX score in patients with coronary heart disease.The higher the MPV value means the more serious the coronary artery lesion.3.MPV was an independent predictor of SYNTAX score greater than 22 for CHD patients.Receiver operating characteristic curve(ROC curve)showed that area under curve was 0.696(95%CI:0.639?0.752,P<0.001).MPV value of 10.25fl was identified as the best effective cut-point in the SYNTAX score>22(sensibility 78.5%,specificity 52.6%).