Comparison of Mean Platelet Volume at Admission in Subtypes of Acute Myocardial Infarction

Abstract

Objectives: Thrombus by the activated platelets and reduced blood flow of myocardium as a result of the thrombus lies under the pathophysiology of acute myocardial infarction (MI). Mean platelet volume (MPV) is known to increase by the activation and rapid turnover of the platelets. This parameter has been shown to increase in acute MI and high levels are associated with poor prognosis. Trials comparing the MPV in ST elevated and non-ST elevated myocardial infarction (MI) patients are so rare in the literature. We aimed to search for the difference in MPV in these 2 types of acute MI. Materials and Methods: We retrospectively searched for the patients followed up because of acute MI in our coronary intensive care unit. MPV was routinely worked up from the admission complete blood count analysis. Patients were compared in two groups as ST elevation MI and non-ST elevation MI. Results: As a result, 356 elligible patients were included in our trial (203 were non-ST elevation patients, 153 were ST elevation patients). Mean patient age was 63 and 29% were female. MPV in non-ST elevation group was significantly higher than ST elevation MI group (10.5±1.2 vs 10.1±1.2, p=0.001). Conclusion: We concluded that MPV, a parameter of platelet reactivity, was significantly higher in patients with non-ST elevated MI. Chronic underlying atherosclerosis, comorbidities and activated platelets probably playing more central role in pathophysiology of this acute MI type may explain these results. In non-ST elevation MI, urgent and appropriate antiaggregant therapy, as explained in the guidelines is as important as it is in ST elevated MI, we believe our results may be important for reminding this issue

Keywords

• Mean Platelet Volume
• St Elevation Myocardial Infarction
• Non-St Elevation Myocardial Infarction

Akut Miyokard İnfarktüsü Alt Tipleri Arasında Başvuru Esnasında Ölçülen Ortalama Trombosit Hacminin Karşılaştırılması

Abstract

Amaç: Akut miyokard infarktüsü (MI) patofizyolojisinde aktive trombositlerin sebep olduğu trombus ve buna bağlı azalan kan akımı ile bozulan miyokard beslenmesi yatmaktadır. Ortalama trombosit hacmi (OTH), artan trombosit aktivitesi ve yıkımıyla artmaktadır. Çalışmalarda akut MI hastalarında bu parametrenin arttığı ve yüksek değerlerin kötü prognoz ile ilişkili olduğu gösterilmiştir. Literatürde ST elevasyonu olan ve olmayan MI hastalarının trombosit aktivitesi açısından kıyaslandığı çok az çalışma mevcuttur. Çalışmamızda bu iki akut MI alt tipini ortalama trombosit hacmi açısından kıyaslamayı planladık. Gereç ve Yöntem: Koroner yoğun bakımımıza akut MI ile kabul edilmiş ve izlenmiş hasta verileri retrospektif olarak tarandı. Başvuru anında alınan kanlardan, tam kan sayımı tetkiki içerisinde OTH analizi otomatik olarak yapıldı. Hastalar ST elevasyonu olan MI ve ST elevasyonu olmayan MI olarak iki grupta kıyaslandı. Bulgular: Sonuç olarak uygunluk kriterlerine uyan 356 hasta çalışmamıza dahil edildi (203 hasta ST elevasyonu olmayan MI, 153 hasta ST elevasyonu olan MI). Ortalama hasta yaşı 63 olup hastaların %29’u kadın idi. ST elevasyonu olmayan MI’da ortalama trombosit hacmi diğer MI tipine kıyasla belirgin olarak daha yüksek bulundu (10,5±1,2 vs 10,1±1,2, p=0,001). Sonuç: ST elevasyonu olan ve olmayan MI hastalarının trombosit aktiviteleri hakkında öngördürücü OTH’nin kıyaslandığı çalışmamızda, ST elevasyonu olmayan MI geçiren hastalarda OTH’nin anlamlı olarak daha yüksek olduğu sonucuna ulaştık. Altta yatan kronik ateroskleroz, komorbiditeler ve patofizyolojide muhtemel daha merkezde rol alan aktive trombositler ile ST elevasyonu olmayan MI’daki bu sonuçları açıklayabilir.Bu hasta grubuna, ST elevasyonu olan MI kadar önem verilerek acil ve kılavuzlara uygun antiagregan tedavinin erkenden başlanmasını vurgulaması açısından sonuçlarımızın önemli olduğunu düşünmekteyiz.

Keywords

• Ortalama Trombosit Hacmi
• St Elevasyonu Olan Miyokard Infarktüsü
• St Elevasyonu Olmayan Miyokard Infarktüsü

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