ABSTRACT
Due to the positive relation between platelet size and platelet reactivity, a high value of the mean platelet volume [MPV] is an independent risk factor to predict acute myocardial infarction [AMI] and its adverse outcome. Few data are available to determinate the prognostic value of MPV in ST-elevation myocardial infarction [STEMI] patients treated with percutaneous coronary intervention [PCI]. The primary purpose of this study was to evaluate the clinical value of MPV to predict impaired reperfusion and in-hospital major adverse cardiovascular events [MACE] in acute STEMI treated with primary PCI. This study included 203 STEMI patients referring for blood sampling before primary PCI to estimate MPV and determine the thrombolysis in myocardial infarction [TIMI] flow grade, corrected TIMI frame count [CTFC], and in-hospital MACE. The frequency of in-hospital MACE in the group of patients with a high MPV [>/= 10.3 ng/dl] was significantly more than that of the group with a low MPV [<10.3 ng/dl] [37.8% vs. 4.4%, P < 0.001]. The no-reflow phenomenon was more frequent in the patients with a high MPV than that of the patients with a low MPV [17.8% vs. 1.9%, P < 0.001]. The mean MPV in the group of patients with CTFC >/= 40 was significantly more than that of the group of patients with CTFC < 40 [10.9 +/- 0.92 vs. 9.45 +/- 0.85, P = 0.001]. After adjustment for baseline characteristics, a high MPV remained a strong independent factor to predict the no-reflow phenomenon [Odds Ratio [OR]=2.263, 95% Confidence Interval [CI] = 1.47 to 5.97; P < 0.002], in-hospital MACE [OR = 2.49, 95% CI = 1.34 to 4.61; P < 0.004], and CTFC >/= 40 [OR=2.09, 95% CI = 1.22 to 3.39; P < 0.003]. These findings confirmed that not only could admission MPV predict impaired reperfusion and in-hospital MACE in acute STEMI patients treated with PCI, but also it could be considered a practical way to determine higher-risk patients