Mean platelet volume as a predictor for long-term outcome after percutaneous coronary intervention.

Mean platelet volume (MPV) is a value that is available from standard blood count. Increased MPV is associated with increased platelet reactivity and it has been correlated with adverse cardiac outcomes in patients with acute coronary syndromes (ACS). However, there is limited information about the prognostic value of baseline MPV in a large heterogenous patient population which undergoes percutaneous coronary intervention (PCI). To examine whether baseline MPV is predictive of clinical outcomes in patients who undergo PCI. Included were consecutive patients who underwent PCI during 2004-2010 (n = 7,585, mean age 67.7 ± 12.1 years, 76.0% males) with a median follow-up period of 4 years. Baseline MPV before angiography and long-term clinical outcomes were assessed. The mean MPV was higher in women as compared to men (8.6 ± 1.2 vs. 8.5 ± 1.1 fL, p = 0.02), in diabetic versus non-diabetic patients (8.6 ± 1.2 vs. 8.4 ± 1.1 fL, p < 0.001) and in patients who were admitted with ACS (n = 4,961) compared to patients who underwent an elective PCI (8.6 ± 1.1 vs. 8.5 ± 1.1 fL, p = 0.001). On multivariate analysis, MPV was associated with mortality (HR 1.18, 95% CI 1.12-1.23, p < 0.001) and with a composite end-point of death, MI and target vessel revascularization (HR 1.09, 95% CI 1.04-1.13, p < 0.001). Baseline MPV was associated with mortality in patients undergoing an elective PCI as well as in urgent PCI (HR 1.30, 95% CI 1.20-1.40, p < 0.001 and HR 1.13, 95% CI 1.07-1.20, p < 0.001, respectively). In patients undergoing either an elective or urgent PCI, an elevated MPV is a significant predictor of cardiovascular adverse events including death.