MEAN PLATELET VOLUME AND PLATELET COUNT: OVERSEEN MARKERS OF HIGH ON-TREATMENT PLATELET REACTIVITY AND WORSE OUTCOME IN PATIENTS WITH ACUTE CORONARY SYNDROME

Sborník

Background. Mean platelet volume (MPV) is a marker of platelet activation and turnover. Platelet count (PC) and platelet hematocrit (PCT) correlate with total volume of platelet cytoplasm rich of proaggregatory substances. It can be expected that increase in these values leads to worse response to antiplatelet treatment and worse outcomes.Objectives: The primary aim of the study was to assess the relationship between MPV, PC, PCT and responsiveness to the antiplatelet treatment. The secondary aim was to assess the relationship between MPV, PC, PCT and mortality in patients with acute coronary syndrome. Patients/methods: We performed a cohort study of 190 patients with acute coronary syndrome. In these patients the MPV, PC and PCT were measured. The response to aspirin and clopidogrel was simultaneously assessed by the impedance aggregometry-based assay.Results. Patients with high MPV were in higher risk of dual poor responsiveness (HR 2.53, 95 % CI 1.15-5.37, p<0.05) and poor responsiveness to aspirin (HR 2.38, 95 % CI 1.37-3.92, p<0.01). Patients with high PC were in higher risk of poor responsiveness to clopidogrel (HR 2.60, 95 % CI 1.07-4.33, p<0.05). The three-year mortality was increased in patients with high MPV (25.7% vs. 13.5%, p<0.05). Conclusions. MPV and PC are useful tools in prediction of response to antiplatelet treatment. Increased MPV is a predictor of increased long-term mortality in patients with acute coronary syndrome

Haematologica, 2012; 97(s1):  419