Mean Platelet Volume to Platelet Count Ratio Predicts Left Atrial Stasis in Patients with Non-Valvular Atrial Fibrillation

Abstract

Background The mean platelet volume to platelet count ratio (MPV/PC) has been investigated in the diagnosis, prognosis and risk stratification in several diseases. However, the predictive role of MPV/PC in left atrial stasis (LAS) of non-valvular atrial fibrillation (NVAF) patients remains unknown. Methods A total of 217 consecutive NVAF patients undergoing transesophageal echocardiogram (TEE) evaluation were retrospectively enrolled. The demographic, clinical, admission laboratory and TEE data were extracted and analyzed. Patients were categorized into those with or without LAS. The associations between the MPV/PC ratio and LAS were assessed by multivariate logistic regression analysis. Results There were 24.9% (n = 54) patients with LAS according to TEE. Compared with patients without LAS, the MPV/PC ratio was significantly higher in those with LAS (5.6±1.6 vs 4.8±1.0, P < 0.001). After multivariable adjustment, higher MPV/PC ratio levels (OR 1.747, 95% CI 1.193–2.559, P = 0.004) were positively associated with LAS, with the optimal cut-point for LAS prediction of 5.36 (area under the curve, AUC = 0.683, sensitivity 48%, specificity 73%, 95% CI 0.589–0.777, P < 0.001). The stratification analysis showed that a significant positive correlation between MPV/PC ratio ≥5.36 and LAS in patients of male, younger (<65 years), paroxysmal AF, without history of stroke/TIA, CHA 2 DS 2 -VASc score ≥2, left atrial diameter (LAD) ≥40mm and left atrial volume index (LAVI) >34mL/m 2 (all P < 0.05). Conclusion Increasing MPV/PC ratio was associated with an increased risk of LAS, which was mainly reflected in the subgroups of male, younger (<65 years), paroxysmal AF, without history of stroke/TIA, CHA 2 DS 2 -VASc score ≥2, LAD ≥40mm and LAVI >34mL/m 2 patients.

Atrial Fibrilation in Coronary Artery Disease Patients: Platelets Characteristics and Echocardiography Indexes

“…At the same time, it decreases in patients with successful CAD treatment [12]. Moreover, MPV/PC ratio directly linked with LA echocardiography characteristics as LAD, LAVI, and stroke risks scales, as CHA2DS2-VASc [13]. The role of MPV in LV hypertrophy development is controversial.…”

Platelet amino acid spectrum and gut microbiota, their links in patients with coronary artery disease and atrial fibrillation

“…Platelets volume, distribution and factors of activity are significantly higher, but platelets count is lower in AF patients. But it is still no evidence about deep pathophysiological plot of this changes [4]. Moreover, platelets condition plays an important role in myocardial inflammation and regulates myocardial reperfusion in during myocardial ischemia [16].…”

“…One of the important sine of platelets activation is an increasing of mean platelets volume, that shows us the morphological platelets changes. So, platelets are an important part of hemostatic balance and they directly affect prothrombotic state [4]. Each AF paroxysm is associated with platelets activation [5].…”