Mean platelet volume may predict early clinical outcome after coronary artery bypass grafting

Abstract

BackgroundAn elevated mean platelet volume is associated with increased platelet activation and thus may predict thrombotic events. The goal of this study was to investigate the association of the mean platelet volume and the major adverse events after coronary artery bypass surgery.MethodsBaseline clinical details and preoperative hematologic parameters were obtained prospectively in 205 consecutive patients undergoing coronary artery bypass surgery. Postoperative mortality and major adverse events were recorded in the early postoperative period (median of 72 days, interquartile range 58.5-109 days).ResultsCombined adverse events occurred in 37 patients (18.0%) during the early follow-up. The preoperative mean platelet volume and hematocrit levels were found to be associated with postoperative adverse events (p<0.001 for both variables). In multivariate logistic regression models, the preoperative mean platelet volume and hematocrit levels were strong independent predictors of combined adverse events after surgery (respectively OR 1.89, p=0.037; OR 0.87, p=0.011). After receiver-operating-characteristics curve analysis, using a cut-point of 8.75 fL, the preoperative mean platelet volume level predicted adverse events with a sensitivity of 54% and specificity of 70%. In a further model with cut-off points, higher preoperative mean platelet volume levels remained a powerful independent predictor of postoperative myocardial infarction (OR 3.60, p=0.013) and major adverse cardiac events (OR 2.53, p=0.045).ConclusionsAn elevated preoperative mean platelet volume is associated with an adverse outcome after coronary artery bypass grafting. In conclusion, we can say that mean platelet volume is an important, simple, readily available, and cost effective tool and can be useful in predicting the postoperative adverse events in patients undergoing coronary artery bypass grafting.

Hematological predictors and clinical outcomes in cardiac surgery

“…It was shown that activated platelets adhere to the endothelium, express adhesion molecules, and function in the induction of the immunological cascade [26]. Therefore, it has been reported in the literature that MPC can be used as an outcome prediction marker in cardiac diseases [4,27]. In a previous study [4] conducted at our hospital, the MPV cutoff value was obtained as 8.75 based on the study population's receiver operating analysis, and we used this value in the present study.…”

“…Therefore, it has been reported in the literature that MPC can be used as an outcome prediction marker in cardiac diseases [4,27]. In a previous study [4] conducted at our hospital, the MPV cutoff value was obtained as 8.75 based on the study population's receiver operating analysis, and we used this value in the present study. We found that MPV is an independent predictor for CAE (1.5 fold); however, similar to RDW, its prediction success was lower than that of NLR (1.5 versus 4.8).…”

“…Because the normal range for RDW is considered to be 11.5-15.6, the cutoff value was set as >15.6. The high threshold for MPV was set as 8.75 [4], and the cutoff values for PLR and NLR were set as 128 [5] and 2.81 [6], respectively.…”

Outcome Prediction After Open Heart Surgery

“…24 During cardiopulmonary bypass multiple processes occur involving platelets, coagulation factors and vascular endothelium promoting the shift of risk from bleeding to thrombosis that manifest as multi-organ complications and worsens the outcome. 25 In 2000, Vuylsteke and his colleagues 26 found that the increased preoperative platelet count was associated with increased heparin resistance due to the increased capacity to produce platelet factor 4 that neutralizes heparin, the platelet count in patients who showed heparin resistance was {252 (221 -270) X 10 3 /mm 3 } while normal patients platelet count was {194 (165-223) X 10 3 /mm 3 }. In our study we found that the preoperative platelet count was higher in non survivors {296.87 ± 66.05 X 10 3 /mm 3 } compared to survivors {236.79 ± 66.92 X 10 3 /mm 3 } and this was supported by the results of Unal et al (2013) 25 who reported that the increased platelet count was correlated with adverse events after CABG with The reported platelet count in their patients with adverse events being 262 ± 66 X 10 3 /mm 3 .…”

Hematological Changes in Patients Undergoing Coronary Artery Bypass Surgery: a Prospective Study

“…Anemia is associated with a range of postoperative consequences (stroke, acute myocardial infarction), major side effects, re-hospitalization, duration of stay in the Intensive Care Unit and hospital stay, mortality 30 days after the intervention ( 5 ). Westenbrink et al ( 6 ) noted that every 1 mg/dl decrease in Hb was associated with a 13% increase in cardiovascular events and 22 % increase in all-cause mortality.…”