Platelet Indices, Infarct Site and In-Hospital Major Adverse Cardiac Events in ST Elevation Myocardial Infarction Patients Undergoing Primary PCI.

Author : A. A. Asrial, A. Pudjiastuti, Haryadi, L Raharjoyo, N. Virginia, Y. Herry
Upload Date : 19-04-2018

Background: The relationship between platelet indices and acute coronary syndrome (ACS) has been reported. The platelet indices like Mean Platelet Volume (MPV) and MPV to platelet ratio (MPV/P) were higher in ST Elevation Myocardial Infarction (STEMI) compared with Non ST Elevation ACS patients, but relationship between these values to infarct site has not been reported. The platelet indices have been reported to be associated with morbidity, mortality and severity of coronary lesion in ACS patients. The aim of this study was to investigate platelet indices relationship with infarct site and in-hospital major adverse cardiac events (MACE) among post primary PCI (PPCI) patients.   

Methods: This was a retrospective study with 50 subjects who underwent PPCI at RSUP dr. Kariadi Semarang. Data were taken from the medical records, echocardiography laboratory and catheterization laboratory records. In-hospital MACE was defined as any death, lethal arrhythmia, stroke or re-infarction during hospitalization.

Results: Anterior STEMI patients undergoing PPCI were younger (48.81±11.21 vs 55.90±9.18; p=0.019), had higher MVP/P ratio (median 0.037 vs 0.029; p=0.014), MVP/P value (median 9.7 vs  8.3; p=0.031) and better clearance creatinine (CrCl) (median 55.61 vs 42; p=0.02). MPV and MPV/P were also higher in patients with in-hospital MACE, but p value was not significant (10.24±1.79 vs 8.55±1.87; p=0.062 and 0.032±0.01vs 0.034±0.01;p=0.69 respectively). In-hospital MACE and mortality were higher in anterior wall MI but not statistically significant.

Conclusion: The MPV and MPV/P ratio were found to be significantly higher in anterior wall STEMI patients. Nevertheless, MACE rate in anterior STEMI patients were not significantly different compared to that of other wall STEMI patients. This finding was probably due to relatively younger age, better CrCl and not significantly lower LVEF in anterior wall MI patients.

KEYWORDS : Platelet indices, infarct site, in-hospital MACE, STEMI, primary PCI

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