Association between Mean Platelet Volume-to-Lymphocyte Ratio and the Presence of Apical Mural Thrombus in Post-Myocardial Infarction Patients

Abstract Background Left ventricular apical thrombus (AT) is generally associated with ischemic and non-ischemic cardiomyopathies. The thrombo-inflammatory process plays an important role in the pathophysiology of acute coronary syndromes and post-myocardial thromboembolic complications. Mean platelet volume (MPV) has been linked to poor prognosis following myocardial infarction. Recently, platelet-to-lymphocyte ratio (PLR) has emerged as a new marker of worse outcomes linking inflammation and thrombosis. Objective We aimed to investigate the prognostic significance of the marker - mean platelet volume to lymphocyte ratio (MPVLR) in patients with AT. Methods Fifty-six patients with left ventricular AT after an anterior myocardial infarction and 51 patients without left ventricular AT after an anterior myocardial infarction were enrolled in this study retrospectively. Admission MPVLR was compared between the two groups. Logistic regression analysis was carried out to identify whether MPVLR is an independent predictor of AT. The receiver operating curve (ROC) analysis was used to show the optimal cut-off for MPVLR to predict AT. P values less than 0.05 were considered statistically significant. Results Age, gender, frequency of diabetes mellitus, hypertension and atrial fibrillation, and ejection fraction values did not differ between the groups. MPVLR was higher in patients with AT than patients without AT (7.91±2.5 vs 5.1±2.1, p<0.001). ROC analysis revealed moderate diagnostic value in predicting the presence of AT with a MPVLR cut-off > 4.75 (82.1% sensivity and 70.2% specifity (area under the curve=0.811, 95% confidence interval [CI]: 0.731-0.891, p<0.001). MPVLR was found to be an independent risk factor for the formation of AT (B:0.441, p.0.001). Conclusion MPVLR is a simple, cheap and easily accessible test that can predict left ventricular AT formation. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Volume Plaquetário Médio está Associado com Reperfusão Inadequada Detectada por Angiografia em Pacientes com Terapia Fibrinolítica Bem Sucedida / Mean Platelet Volume is Associated with Inadequate Reperfusion Detected by Angiography in Patients with Successful Fibrinolytic Therapy

Fundamento: Volume plaquetário médio (VPM) elevado está associado com falha na fibrinólise e eventos adversos em pacientes com infarto agudo do miocárdio com supradesnivelamento do segmento ST (IAMCSST). No entanto, não há dados sobre os efeitos do VPM sobre o fluxo sanguíneo coronariano anterógrado e o grau de reperfusão em pacientes com fibrinólise bem sucedida. Objetivo: O objetivo deste estudo foi investigar o papel do VMP sobre a circulação coronariana via contagem de quadros angiográficos (TFC) na trombólise no infarto do miocárdio (TIMI) após terapia fibrinolítica bem sucedida. Métodos: Entre 145 pacientes tratados com agentes fibrinolíticos, 123 (84,8%) pacientes consecutivos com fibrinólise bem sucedida, determinados por eletrocardiografia, foram incluídos. Os pacientes foram divididos em dois grupos de acordo com TFC. Um TCF > 40 foi considerado como um marcador de reperfusão inadequada, e um TCF ≤ 40 aceito como um indicador de reperfusão completa. Resultados: Após a angiografia coronária, 57 pacientes apresentaram TFC ≤ 40 e 66 pacientes apresentaram TFC > 40. O VPM foi significativamente mais alto no grupo com reperfusão inadequada (8,93 ± 0,87 fl vs. 7,92 ± 0,80 fl, p < 0,001). Um VPM elevado foi identificado como um indicador de reperfusão inadequada, e coordenadas da curva ROC indicaram um ponto de corte de 8,3 fl para VPM. Conclusão: VPM elevado na admissão em pacientes com IAMCSST tratados com terapia fibrinolítica bem sucedida associou-se com reperfusão inadequada detectada por TFC

Background: Higher Mean platelet volume (MPV) is associated with fibrinolysis failure and adverse outcomes in patients with ST elevation myocardial infarction (STEMI). However, there are no data about the effects of MPV on antegrade coronary blood flow and the degree of reperfusion in patients with successful fibrinolysis. Objective: The aim of our study was to investigate the role of MPV on coronary circulation via thrombolysis in myocardial infarction (TIMI) frame count (TFC) after successful fibrinolytic therapy. Methods: Among 145 patients treated with fibrinolytics, 123 (84.8%) consecutive patients with successful fibrinolysis determined by electrocardiography criteria were included. The patients were divided into two groups according to TFC. TFC > 40 was accepted as a marker for inadequate reperfusion and TFC ≤ 40 was accepted as an indicator of complete reperfusion. Results: After coronary angiography, 57 patients had TFC ≤ 40 and 66 patients had TFC > 40. MPV was significantly higher in the inadequate reperfusion group (8.93 ± 0.87 fl vs 7.92 ± 0.80 fl, p < 0.001). Higher MPV was found to be an indicator of inadequate reperfusion and coordinates of the ROC curve indicated a cutoff value of 8.3 fl for MPV. Conclusion: Higher MPV on admission in STEMI patients treated with successful fibrinolytic therapy was found to be associated with inadequate reperfusion detected by TFC