Platelet distribution width predicts left ventricular dysfunction in patients with acute coronary syndromes treated with percutaneous coronary intervention

Abstract

A b s t r a c t Background:The role of platelets in the pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are a matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be a valuable predicting factor in cardiac patients. However, platelet distribution width (PDW) is reported to be a more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is an up-to-date subject of research. PDW values in the assessment of left ventricular (LV) function have not been previously studied. Aim:The aim of the study was to evaluate whether admission PDW can predict LV systolic function in patients with ACS treated with stent implantation.Methods: On-admission PDW was measured in 278 consecutive patients with diagnosis of ACS, who underwent stent(s) implantation. Echocardiogram with LV ejection fraction (LVEF) estimation was performed within 24 h of percutaneous coronary intervention. Additionally, patients were under one-year follow-up, and one-year all-cause mortality was assessed.Results: According to receiver-operating characteristics (ROC) analysis, a PDW value greater than 12.8 fL could predict LVEF ≤ 35% with sensitivity of 81% and specificity of 39% (AUC 0.614; p = 0.0177). Only a trend was noted in ROC for PDW and one-year mortality (AUC 0.608; p = 0.0815). Multivariate logistic regression analysis has shown that the PDW parameter correlates independently with both systolic heart failure with LVEF ≤ 35% (PDW cut-off: 12.8 fL, OR 2.8107, CI 1.1401-6.9293, p = 0.0248) and one-year mortality (PDW cut-off: 16 fL, OR 2.6750, CI 1.0190-7.0225, p = 0.0457).Conclusions: Admission PDW may serve as a simple and widely available predictor of impaired LV function in patients with ACS. Association between PDW and mortality needs to be confirmed in larger studies.

Value of Hematological and Coagulation Parameters as Prognostic Factors in Acute Coronary Syndromes

“…In our study, no correlation was found between PDW and the severity and extent of coronary artery disease and similar results were observed in a prospective study performed by Luca et al [ 53 ]. PDW correlates with the occurrence of heart failure in patients with ACS after PCI in the study of Kowara et al [ 54 ] and also our study PDW was found to be a predictor for in-hospital heart failure development in ACS patients.…”

Platelet distribution width as the prognostic marker in coronary bifurcation treatment

“…Also, other authors analysed the PDW as a marker in patients with acute myocardial infarction . Similarly, to our study, the PDW value above 16 fL was the risk factor of the unfavourable outcome.…”

The Role of Hematological Indices in Patients with Acute Coronary Syndrome

“…PDW measured on admission is a cheap and generally available biomarker which allows for predicting the development of heart failure in patients with ACS after PCI [ 60 ]. Bekler et al showed that an increased level of PDW (>17%) was related to the severity of CAD in patients with ACS.…”