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High mean platelet volume to platelet count ratio as a predictor on poor outcomes after CABG

  • Mehmet Erin TüysüzEmail author
  • Mehmet Dedemoğlu
Original Article
  • 32 Downloads

Abstract

Objectives

To determine the effect of mean platelet volume (MPV) to platelet count (PC) ratio on postoperative poor outcomes, early mortality and long-term survival rate in patients undergoing CABG.

Methods

Between February 2016 and September 2018, all patients undergoing CABG in our department were retrospectively reviewed. A total of 213 consecutive patients were included in the study.

Results

Mean age was 61.5 ± 9.7 years and mean follow-up of all patients was 1.4 ± 0.5 years. All patients were divided into two groups as high and low MPV/PC ratio in terms of 3.825 of cut-off point. 72 patients had a high MPV/PC ratio, whereas, 141 patients had low MPV/PC ratio. The rates of reoperation for early vein-graft occlusion, low cardiac output syndrome and respiratory complication were significantly higher in group 1 (p = 0.03, 0.04 and 0.01). The mean hospital length of stay was higher in group 1 (p = 0.03). MPV/PC ratio for reoperation for early vein-graft occlusion; MPV and ejection fraction for low cardiac output syndrome; hyperlipidemia, chronic renal failure history and MPV/PC ratio for sepsis; male gender, CRF history and CPB time for atrial fibrillation; age, congestive heart failure history, myocardial infarction history and CPB time for the early mortality were found to be independent predictors. Peripheral arterial diseases, USAP and MPV/PC ratio were found to be independent predictors for the late mortality.

Conclusions

A high MPV/PC ratio is associated with early vein-graft occlusion and poor postoperative outcomes in the early period after CABG. Furthermore, it has a negative effect on late survival.

Keywords

Coronary artery bypass grafting Coronary artery disease Mean platelet volume Mean platelet volume to platelet count ratio Platelet count 

Notes

Acknowledgements

The authors thank to Hüseyin Narcı for his help in preparing this study.

Compliance with ethical standards

Conflicts of interest

The authors report no conflict of interest.

References

  1. 1.
    Montrief T, Kofyman A, Long B. Coronary artery bypass graft surgery complications: a review for emergency clinicians. Am J Emerg Med. 2018;36:2289–97.CrossRefGoogle Scholar
  2. 2.
    Kaya U, Kora Y. Predictive value of mean platelet volume in saphenous vein graft disease. Braz J Cariovasc Surg. 2018;33:317–22.Google Scholar
  3. 3.
    Tsiara S, Elisaf M, Mikhailidis DP. Platelets as predictors of vascular risk: is there a practical index of platelet activitiy? Clin Appl Thromb Hemost. 2003;9:177–90.CrossRefGoogle Scholar
  4. 4.
    Sansanayudh N, Numthavaj P, Muntham D, et al. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost. 2015;114:1299–309.Google Scholar
  5. 5.
    Biricik S, Narcı H, Dündar GA, et al. Mean platelet volume and the ratio of mean platelet volume to platelet count in the diagnosis of acute appendicitis. Am J Emerg Med. 2019;37:411–4.CrossRefGoogle Scholar
  6. 6.
    Azab B, Torbey E, Singh J, et al. Mean platelet volume/platelet count ratio as a predictor of long-term mortality after non-ST-elevation myocardial infarction. Platelets. 2011;22:557–66.CrossRefGoogle Scholar
  7. 7.
    Oh GH, Chung SP, Park YS, et al. Mean platelet volume to platelet count ratio as a promising predictor of early mortality in severe sepsis. Shock. 2017;47:323–30.CrossRefGoogle Scholar
  8. 8.
    Kesmarky G, Toth K, Habon L, et al. Hemorheological parameters in coronary artery disease. Clin Hemorheol Microcirc. 1998;18:245–51.Google Scholar
  9. 9.
    Pizzuli L, Yang A, Martin JF, et al. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J. 1998;19:80–4.CrossRefGoogle Scholar
  10. 10.
    Lance MD, Sloep M, Henskens YM, et al. Mean platelet volume as a diagnostic marker for cardiovascular disease: drawbacks of preanalytical conditions and measuring techniques. Clin Appl Thromb Hemost. 2012;18:561–8.CrossRefGoogle Scholar
  11. 11.
    Yazici HU, Poyraz F, Sen N, et al. Relationship between mean platelet volume and ventricular systolic function in patients with metabolic syndrome and ST-elevation myocardial infarction. Clin Invest Med. 2011;34:E330.CrossRefGoogle Scholar
  12. 12.
    Tandhaulow E, Erikssen J, Sanvik L, et al. Blood platelet count and function are related to total and cardiovascular death in apparently healthy men. Circulation. 1991;84:613–7.CrossRefGoogle Scholar
  13. 13.
    Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eu Heart J. 2001;22:1561–71.CrossRefGoogle Scholar
  14. 14.
    Jennings LK. Mechanisms of protect against platelet-mediated atherothrombosis. Thromb Haemost. 2009;102:248–57.CrossRefGoogle Scholar
  15. 15.
    Galis ZS, Khatri JS. Matrix metalloproteinases in vascular remodeling and atherogenesis: the good, the bad, and the ugly. Circ Res. 2002;90:251–62.CrossRefGoogle Scholar
  16. 16.
    Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17:47–58.CrossRefGoogle Scholar
  17. 17.
    Nakahata N. Thromboxane A2: physiology/pathophysiology, cellular signal transduction and pharmacology. Pharmacol Ther. 2008;118:18–35.CrossRefGoogle Scholar
  18. 18.
    Choudhury A, Chung I, Blann AD, et al. Platelet surface CD62P and CD63, mean platelet volume, and soluble/platelet P-selectin as indexes of platelet function in atrial fibrillation: a comparison of “healthy control subjects” and “disease control subjects” in sinus rhythm. J Am Coll Cardiol. 2007;49:1957–64.CrossRefGoogle Scholar
  19. 19.
    Li DZ, Chen QJ, Sun HP, et al. Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection. Blood Coagul and Fibrinolysis. 2016;27:653–9.CrossRefGoogle Scholar
  20. 20.
    Bomb R, Oliphant CS, Khouzam RN. Dual antiplatelet therapy after coronary artery bypass grafting in the setting of acute coronary syndrome. Am J Cardiol. 2015;116:148–54.CrossRefGoogle Scholar
  21. 21.
    Patrono C. Aspirin resistance: definition, mechanism and clinical read-outs. J Thtromb Haemost. 2003;1:1710–3.CrossRefGoogle Scholar
  22. 22.
    Gluckman TJ, McLean RC, Schulman SP, et al. Effects of aspirin responsiveness and platelet reactivity on early vein graft thrombosis after coronary artery bypass graft surgery. J Am Coll Cardiol. 2011;1:1069–77.CrossRefGoogle Scholar
  23. 23.
    Kayacıoglu I, Gunay R, Saskin H, et al. The role of clopidogrel and acetylsalicylic acid in the prevention of early-phase graft occlusion due to reactive thrombocytosis after coronary artery bypass operation. Heart Surg Forum. 2008;11:E152–157.CrossRefGoogle Scholar
  24. 24.
    Gao G, Zheng Z, Pi Y, et al. Aspirin plus clopidogrel therapy increases early venous graft patency after coronary artery bypass surgery a single-center, randomized, controlled trial. J Am Coll Cardiol. 2010;56:1639–43.CrossRefGoogle Scholar
  25. 25.
    Cadroy Y, Bossavy JP, Thalamas C, et al. Early potent antithrombotic effect with combined aspirin and a loading dose of clopidogrel on experimental arterial thrombogenesis in humans. Circulation. 2000;101:2823–8.CrossRefGoogle Scholar
  26. 26.
    Greinacher A. Platelet activation by heparin. Blood. 2011;117:4686–7.CrossRefGoogle Scholar
  27. 27.
    Jaumdally RJ, Varma C, Blann AD, et al. Platelet activation in coronary artery disease: intracardiac vs peripheral venous levels and the effects of angioplasty. Chest. 2007;132:1532–9.CrossRefGoogle Scholar
  28. 28.
    Gao C, Boylan B, Fang J, et al. Heparin promotes platelet responsiveness by potentiating αIIbβ-mediated outside-in signaling. Blood. 2011;117:4946–52.CrossRefGoogle Scholar
  29. 29.
    Fujita S, Takeda Y, Kizawa S, et al. Platelet volume indices are associated with systolic and diastolic cardiac dysfunction, and left ventricular hypertrophy. BMC Cardiovasc Disord. 2015;15:52.CrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular SurgeryMersin City Training and Research HospitalMersinTurkey
  2. 2.Department of Pediatric Cardiovascular SurgeryMersin City Training and Research HospitalMersinTurkey

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