open access

Vol 75, No 1 (2017)
Original articles
Published online: 2016-09-09
Submitted: 2016-06-23
Accepted: 2016-08-29
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Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention

Michał Kowara, Kajetan Grodecki, Zenon Huczek, Dominika Puchta, Katarzyna Paczwa, Bartosz Rymuza, Karol Zbroński, Krzysztof J. Filipiak, Grzegorz Opolski
DOI: 10.5603/KP.a2016.0137
·
Pubmed: 27714719
·
Kardiol Pol 2017;75(1):42-47.

open access

Vol 75, No 1 (2017)
Original articles
Published online: 2016-09-09
Submitted: 2016-06-23
Accepted: 2016-08-29

Abstract

Background: The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied.  

Aim: The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.  

Methods: On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.  

Results: According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401–6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190–7.0225, p = 0.0457).  

Conclusions: Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.   

Abstract

Background: The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied.  

Aim: The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.  

Methods: On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.  

Results: According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401–6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190–7.0225, p = 0.0457).  

Conclusions: Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.   

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Keywords

platelet distribution width, left ventricular ejection fraction, percutaneous coronary intervention

About this article
Title

Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 75, No 1 (2017)

Pages

42-47

Published online

2016-09-09

DOI

10.5603/KP.a2016.0137

Pubmed

27714719

Bibliographic record

Kardiol Pol 2017;75(1):42-47.

Keywords

platelet distribution width
left ventricular ejection fraction
percutaneous coronary intervention

Authors

Michał Kowara
Kajetan Grodecki
Zenon Huczek
Dominika Puchta
Katarzyna Paczwa
Bartosz Rymuza
Karol Zbroński
Krzysztof J. Filipiak
Grzegorz Opolski

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