Background: Mean platelet volume (MPV) is a strong predictor of impaired angiographic reperfusion and 6-month mortality in ST-elevation myocardial infarction (MI) treated with primary percutaneous coronary intervention (PCI). No data is available for other platelet volume indices: platelet distribution width (PDW) and platelet large cell ratio (P-LCR). The aim was to assess the impact of 3 platelet volume indices on long-term prognosis in patients treated PDW < 16 fL (17.4% vs. 6.3%, p = 0.0012). PDW was found to be an independent prognostic factor for cardiac mortality and composite endpoint. Conclusions: Mean platelet volume, platelet distribution width and platelet large cell ratio measured on admission are strong, independent prognostic factors in PCI-treated acute MI. (Cardiol J 2013; 20, 5: 491-498)

HIGM syndrome is a group of primary immunodeficiency disorders characterized by recurrent bacterial and opportunistic infections; it is also associated with normal to elevated serum IgM levels and a concomitant deficiency of IgG, IgA, and IgE. In this report, we give account of a boy with X-linked HIGM and a novel Y172C mutation within his CD40LG gene. He presented with severe neutropenia as the dominating symptom. His bone marrow showed maturation arrest at the promyelocyte/myelocyte stage, typical of congenital neutropenia. This boy suffered from life-threatening infections and required high doses of rhG-CSF, and a haploidentical PBSCT was also successfully performed, thus leading to reconstitution of CD40L expression on activated CD4+ T cells (as assessed with flow cytometry six months after the procedure). Two low-dose T-cell addbacks were required to re-establish full donor chimerism and clear CMV reactivation. The report demonstrates that in select cases, alternative donor allogeneic HSCT supported by DLI may be effective in correcting the defect in X-linked HIGM, and HSCT in HIGM children is not necessarily limited to matched sibling donor transplantation.

INTROduCTION The significance of coronary collateral circulation in the prognosis of patients after myocardial infarction remains disputable.ObjECTIvEs The aim of the study was to evaluate the effect of coronary collateral circulation, assessed by the Rentrop score, on long-term prognosis in patients treated with primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI).PATIENTs ANd mEThOds Coronary collateral flow was assessed by angiography in 330 patients with myocardial infarction using the Rentrop score. Patients were followed up for the mean period of 26 ±12 months with the clinical endpoints of cardiac death, nonfatal reinfarction, and repeat percutaneous or surgical revascularization.REsuLTs Collateral circulation was graded Rentrop 0 in 39%, Rentrop 1 in 36%, Rentrop 2 in 18%, and Rentrop 3 in 7% of the patients. The mortality rate was 8.7%. Reinfarction occurred in 4.7% of the subjects, and repeat coronary revascularization was performed in 10.9% of the patients. These endpoints were not correlated with the degree of collateral circulation. A significant inverse association was observed between the Rentrop score and the infarct-related artery antegrade flow (P <0.001).CONCLusIONs The degree of collateral circulation assessed by the Rentrop score during primary PCI is not a useful long-term prognostic factor in the population with STEMI in the current therapeutic approach. This may result from the negative correlation between the Rentrop score and the degree of blood flow in the infarct-related artery. Thus, collateral circulation in a patient with STEMI should not discourage intensive cardiovascular risk factor control in secondary prevention of coronary artery disease.

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