Prognostic value of a level of decrease in mean platelet volume (MPV), platelet distribution width (PDW), and platelet large cell ratio (P-LCR) for major adverse cardiovascular events after myocardial infarction without ST-segment elevation: an observational study

Abstract

The current study aimed to explore whether the level of decrease in platelet distribution width (PDW), platelet large cell ratio (P-LCR), and mean platelet volume (MPV) has prognostic value for major adverse cardiovascular events (MACEs) in acute myocardial infarction without ST-segment elevation (NSTEMI) treated by clopidogrel. In this prospective observational cohort study, PDW, P-LCR, and MPV were determined on admission at the hospital and 24 hours after clopidogrel treatment in 170 non-STEMI patients. MACEs were assessed over a one-year follow-up period. Using the Cox regression test, a decrease in PDW showed a significant association with the incidence of MACEs (OR 0.82, 95% CI 0.66-0.99, p=0.049) and overall survival rate (OR 0.95, 95% CI=0.91-0.99, p=0.016). Patients with a decrease in PDW<9.9% had a higher incidence of MACEs (OR 0.42, 95% CI 0.24-0.72, p=0.002) and a lower survival rate (OR 0.32, CI95%=0.12-0.90, p=0.03) than patients who had a decrease in PDW9.9%. In the Kaplan‒Meier analysis using log-rank test, patients who had a decrease in PDW<9.9% had an increased risk for MACEs (p=0.002) and lethal outcomes (p=0.002). However, a decrease in MPV or PLC-R did not have prognostic value. A decrease in PDW<9.9% measured 24 hours after clopidogrel treatment in NSTEMI patients has good prognostic value for determining the short-term risks of MACEs, possibly providing a better risk stratification of those patients.

Easily applicable predictive score for MPR based on parameters before neoadjuvant chemoimmunotherapy in operable NSCLC: a single-center, ambispective, observational study

“…The activity and enzymes of larger platelets are more active compared to small platelets, and the release of thrombotic and inflammatory agents from them can lead to specific complications related to diseases 57 . Previous studies have explored the use of platelet parameters to predict complications like diabetic kidney disease in type 2 diabetes, major adverse cardiovascular events in myocardial infarction 58 , 59 . Although, platelet’s role was involved in immune system and surveillance, platelet indices has not been explored in cancer immunotherapy.…”