Mean Corpuscular Volume Predicts Adverse Outcomes Following Peripheral Angioplasty With Stenting and Is Associated With On-Treatment Platelet Reactivity

Abstract

Structural aspects of red blood cells have been associated with cardiovascular disease. No data linking mean corpuscular volume (MCV) to clinical outcomes and on-treatment platelet reactivity in patients with peripheral artery disease (PAD) are available. We investigated a composite of atherothrombotic events and target vessel restenosis or reocclusion following infrainguinal stenting for stable PAD. Residual platelet reactivity was measured by light transmission aggregometry (LTA) and the VerifyNow assays. We included 104 patients receiving dual antiplatelet therapy (DAPT) with aspirin and clopidogrel. In receiver-operating characteristic analysis, MCV effectively discriminated between patients with and without adverse outcomes and identified a MCV ≤90.8 fL as optimal cutoff. Adverse outcomes occurred significantly more often in patients with low MCV (log-rank P = .002). In univariable Cox regression analysis, low MCV was associated with an increased risk of future adverse outcomes (hazard ratio [HR]: 2.662 [95%CI: 1.304-5.434]; P = .007) and remained significantly associated after adjustment (HR: 2.591 [95%CI: 1.242-5.403]; P = .011). Mean corpuscular volume was inversely correlated with arachidonic acid (AA)- and adenosine diphosphate (ADP)-inducible platelet reactivity by LTA and with the VerifyNow aspirin assay. Low MCV is associated with adverse outcomes over 2 years following infrainguinal stenting. Mean corpuscular volume correlates inversely with AA- and ADP-inducible platelet reactivity during DAPT.

Assessment of Hematological Predictors via Explainable Artificial Intelligence in the Prediction of Acute Myocardial Infarction

“…This parameter helps clinicians identify erythrocyte-related abnormalities and the type of anemia [59,60]. In the previous study, it was found that MCV, MCH, and PDW levels predicted oxidative stress in patients with STEMI [61]. In one study, patients with peripheral artery disease with low MCV levels were found to have significantly higher percutaneous intervention-related major cardiovascular events (MACE) [62].…”

Relationship between mean corpuscular volume and 30-day mortality in patients with intracerebral hemorrhage: Evidence from the MIMIC-III database

“…Recently, an association between MCV and mortality has been reported in patients presenting different diseases, such as resectable esophageal cell carcinoma, [9] chronic kidney disease, [10] liver cancer, [11] colorectal cancer, [12] and acute decompensated heart failure (ADHF). [13] In addition, MCV has been related to clinical outcomes after cardiac surgery, [14] coronary intervention, [15] chronic hemodialysis, [16] peripheral angioplasty with stenting, [17] and pancreaticoduodenectomy. [18] However, there is a lack of available information on MCV levels and clinical outcomes in ICH patients.…”