Increased Mean Platelet Volume is Associated with Decreased Survival in Patients Supported with Impella

M. Harutyunyan, K. Doshi, H. Nazeer, E. Joye, O. Saeed, M. Torosoff, U. Jorde, D. Belov

Research output: Contribution to journalArticle

Abstract

PURPOSE: Increased mean platelet volume (MPV) has been associated with elevated risk of stroke and myocardial infarction in the general population and stroke/pump thrombosis in Heartmate II recipients. It has been proposed that contact with foreign surfaces and centrifugation promote prothrombotic states with platelet activation and increased MPV. An association between MPV and outcomes of patients treated with percutaneous short-term circulatory devices has not been investigated. METHODS: This was a retrospective study of 67 patients who received percutaneously inserted ventricular assist device (pVAD) support for high risk percutaneous coronary interventions. Mean platelet volume (MPV) was measured by impedance technology with Sysmex XN-10 hematological analyzer and expressed in femtoliters (fL). Average MPV (aMPV) and percentage change from admission (∆MPV%) were calculated. RESULTS: All patients experienced rise in MPV during the hospital stay (10.7+/-0.9 pre-pVAD, 10.8+/-0.8 in 24hrs post pVAD, and 11.1+/-1 fL at 7d, p<0.0001). However, MPV increase was more pronounced in the 24 patients (34.5%) who expired in the hospital (Figure A) and the ∆MPV% was significantly higher in expired patients (7.7+/-7.8 vs. 4.6+/-4.9% in survivors, p=0.026). When adjusted for clinical variables (age, gender, and histories of atrial fibrillation, hypertension, coronary artery disease, and congestive heart failure), every 1% increase in ∆MPV% was associated with 11% increased odds of dying in patients undergoing high risk PCI with pVAD support (OR 1.111, 95%CI 1.015-1.216, p=0.022). CONCLUSION: This pilot study indicates that rise in MPV is associated with increased mortality in PCI patients treated with pVAD. Simple and widely available MPV measurements may be useful in identifying high risk patients and estimating prognosis, which may aid in proper resource allocation. More studies on this subject are necessary.

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine
  • Transplantation

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