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Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection

Li, Dong-Ze; Chen, Qing-Jie; Sun, Hui-Ping; Zeng, Rui; Zeng, Zhi; Gao, Xiao-Ming; Ma, Yi-Tong; Yang, Yi-Ning

Blood Coagulation & Fibrinolysis: September 2016 - Volume 27 - Issue 6 - p 653–659
doi: 10.1097/MBC.0000000000000449
ORIGINAL ARTICLES
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Type A acute aortic dissection is a life-threatening vascular emergency because of its high morbidity and mortality. Platelet is a pivotal ingredient involved in the development of acute aortic dissection. In this study, we aimed to investigate whether mean platelet volume (MPV)/platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection. In this single-center and prospective cohort study, 106 consecutive patients with Stanford type A acute aortic dissection admitted to the hospital within 12 h after onset were recruited. The best cut-off value of MPV/platelet count ratio predicting all-cause mortality was determined by the receiver operator characteristic analysis. Patients were divided into high (H-MPV/platelet count) and low (L-MPV/platelet count) groups based on the cut-off value of 7.49 (102 fl/109/l). Patients were followed up for 3.5 years. Of the 106 acute aortic dissection patients, 71 (67.0%) died during the study period, with a median follow-up duration of 570 days. Compared to the L-MPV/platelet count group, patients with H-MPV/platelet count had a higher risk of in-hospital complications including hypotension, hypoxemia, myocardial ischemia/infarction, conscious disturbance, pericardial tamponade, paraplegia, and poor survival (all P < 0.05). In multivariable Cox regression models adjusted for potential confounders, MPV/platelet count ratio was positively associated with the hazard of all-cause mortality, irrespective of interventions either with medication only or urgent surgery, and the hazard ratios were 2.81 (95% confidence interval 1.28–4.48) for the H-MPV/platelet count group when taking L-MPV/platelet count group as the reference (P = 0.005). The MPV/platelet count ratio was a strong independent predictor for in-hospital complications and long-term mortality in patients with type A acute aortic dissection.

aDepartment of Cardiology, First Affiliated Hospital of Xinjiang Medical University, Urumqi

bDepartment of Cardiology, West China Hospital, Sichuan University, Chengdu

cXinjiang Key Laboratory of Cardiovascular Disease Research

dClinical Research Institute of Xinjiang Medical University, Urumqi, China

eBaker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia

*Dong-Ze Li and Qing-Jie Chen contributed equally to the writing of this article.

Correspondence to Professor Yi-Ning Yang, MD, PhD, Department of Cardiology, First Affiliated Hospital of Xinjiang Medical University, No. 137 Liyushan South Road, Urumqi 830054, Xinjiang, ChinaTel: +86 991 4361690; fax: +86 991 4365330; e-mail: yangyn5126@163.com

Received 31 July, 2015

Revised 4 September, 2015

Accepted 12 September, 2015

Copyright © 2016 YEAR Wolters Kluwer Health, Inc. All rights reserved.