Document Detail


Association between admission mean platelet volume and coronary patency after thrombolytic therapy for acute myocardial infarction.
MedLine Citation:
PMID:  20473008     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: High levels of mean platelet volume (MPV) have been shown to be a predictor of poor clinical outcome among survivors of myocardial infarction. We evaluated the association between admission MPV and infarct-related artery (IRA) patency in patients treated with thrombolytic therapy for acute myocardial infarction (AMI). STUDY DESIGN: We retrospectively evaluated 133 consecutive patients with ST-elevation AMI, who received thrombolytic therapy within 12 hours of chest pain. Sixty-five patients received streptokinase and 68 patients received recombinant tissue-type plasminogen activator, based on the discretion of the physician. Blood samples were taken before thrombolytic therapy and MPV was measured. Coronary angiography was performed within a mean of two days after thrombolytic therapy and the flow in the IRA was assessed with the TIMI flow grade and corrected TIMI frame count (CTFC). RESULTS: After thrombolytic therapy, TIMI 3 flow was achieved in 62 patients (46.6%), whereas 71 patients (53.4%) had insufficient TIMI flow. Patients with insufficient TIMI flow had a significantly higher mean admission MPV (9.8+/-1.5 fl vs. 8.6+/-1.4 fl; p<0.001) and were more likely to have been given streptokinase (p=0.02). The two groups were similar with respect to the type of IRA and the number of diseased vessels (p>0.05). There was a weak correlation between MPV and CTFC (p=0.01). Multivariate analysis showed MPV (OR 1.871, 95% CI 1.402-2.498; p<0.001) and the type of thrombolytic agent (OR 2.915; 95% CI 1.333-6.374; p=0.007) as independent predictors of insufficient TIMI flow. The receiver operating characteristic analysis yielded a cutoff value of 8.885 fl for MPV to predict insufficient TIMI flow, with sensitivity and specificity being 70.4% and 66.1%, respectively. CONCLUSION: Our findings show that a higher admission MPV is associated with an increased risk for insufficient TIMI flow in the IRA after thrombolytic therapy for AMI.
Authors:
Ayşe Saatci Yaşar; Emine Bilen; Isa Oner Yüksel; Uğur Arslantaş; Fatih Karakaş; Ozgür Kirbaş; Mehmet Bilge
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır     Volume:  38     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  85-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Atatürk Education and Research Hospital, Ankara, Turkey. drasaatciyasar@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography
Coronary Vessels / physiopathology*
Humans
Myocardial Infarction / blood,  drug therapy*
Patient Admission
Platelet Count*
Streptokinase / therapeutic use*
Thrombolytic Therapy / methods*
Tissue Plasminogen Activator / therapeutic use*
Vascular Patency / physiology*
Chemical
Reg. No./Substance:
EC 3.4.-/Streptokinase; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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