Mean Platelet Volume as Prognostic Marker in Patients with Acute Coronary Syndrome

Background: Mean platelet volume (MPV) has been described as a predictor of cardiovascular events in patients with acute coronary syndrome. However, there is limited evidence of its role as prognostic marker in elderly patients. Objective: The aim of this study was to evaluate whether MPV is an independent predictor of events during follow-up of patients over 65 years of age with acute coronary syndrome. Methods: This prospective study included patients over 65 years with ST-segment elevation or non ST-segment elevation acute coronary syndrome. They were divided into two groups: high MPV (10.9 fL- 3rd tertile) and low MPV (<10.9 fL -1st and 2nd tertile). Different clinical variables were analyzed and the TIMI and GRACE scores were calculated. The primary endpoint was the composite of all-cause mortality and cardiovascular readmission (for acute coronary syndrome, heart failure and stroke) over the follow-up period. Results: A total of 250 patients were included in the study. Mean age was 74±7 years and 44% were women. Eighty-five patients presented with high and 165 with low MPV. Median follow-up was 302 days (interquartile range 130-558) and the primary endpoint was observed in 17.6% of cases (44 patients). In the multivariate Cox regression analysis, high MPV [HR 7.23 (95% CI 2.47-11.6); p=0.001], and TIMI [HR 3.10 (95% CI 1.46-6.59); p=0.03] and GRACE [HR 1.02 (95% CI 1.01-1.07); p=0.002] high risk scores were independent predictors of the primary endpoint. The area under the curve for MPV was 0.71 (95% CI 0.59-0.82), p=0.001. Conclusions: In our population, MPV emerged as an independent predictor of the composite endpoint, adjusted for other variables as the TIMI and GRACE scores.INTRODUCCIÓN Se ha descripto al volumen plaquetario medio (VPM) como predictor de eventos cardiovasculares en pacientes con SCA. Hay poca evidencia en pacientes añosos. El objetivo de este trabajo es evaluar si el VPM es un predictor independiente de eventos en el seguimiento en pacientes mayores de 65 años con SCA. MATERIALES Y METODOS Estudio prospectivo que incluyó pacientes mayores de 65 años con SCA con y sin elevación del ST. Se dividieron en dos grupos: VPM alto (≥ 10,9 fL- tercilo 3) y VPM bajo (