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Mean platelet volume and clinical outcomes of patients with chest pain discharged from internal medicine wards

Beeri, Gila,,*; Topaz, Guyb,,*; Hershko, Alon Y.c,,e; Leader, Avid,,e; Kitay-Cohen, Yonab,,e; Pereg, Davida,,e

doi: 10.1097/MCA.0000000000000760
Risk Stratification
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Background Currently, there are no clinical scores for risk stratification of low-risk patients with chest pain. We aimed to examine the association between mean platelet volume (MPV) and risk for adverse clinical outcomes in patients with chest pain discharged from internal medicine wards following acute coronary syndrome (ACS) rule-out.

Patients and methods Included were patients who were admitted to internal medicine wards and were discharged following an ACS-rule-out during 2010–2016. The primary endpoint was the composite of all-cause mortality and hospital admission due to ACS at 30-days following hospital discharge.

Results Included in the study were12 440 patients who were divided into three groups according to MPV. The composite endpoint of 30-day all-cause mortality and hospital admission for ACS occurred more frequently among patients with high MPV. Each one-point increase in MPV was associated with an 18% increase in the risk for the composite endpoint (P = 0.02). Considering patients with MPV less than 7.8 fl as the reference group yielded adjusted hazard ratios for the composite endpoint that was significantly higher in patients in the high MPV tertile ( > 8.8 fl) (hazard ratio 1.6; 95% confidence interval = 1.1–2.5; P = 0.04). Each one-point increase in MPV was associated with an 11% increase in the risk for 1-year all-cause mortality (P = 0.01) and a 10% increase in the risk for 1-year ACS (P = 0.04).

Conclusion We found an independent association between high MPV and the risk of death and ACS among patients with chest pain who were discharged from internal medicine wards following an ACS-rule-out. MPV may be combined in the risk stratification of patients with chest pain.

The current study was aimed to examine the association between mean platelet volume (MPV) and risk for adverse clinical outcomes in patients with chest pain discharged from internal medicine wards following ACS rule-out. Included in the study were 12,440 patients who were divided into 3 groups according to MPV. The composite endpoint of 30-day all-cause mortality and hospital admission for ACS occurred more frequently among patients with high MPV. Each 1 point increase in MPV was associated with an 18% increase in the risk for the composite endpoint (p=0.02).Considering patients with MPV<7.8fl as the reference group yielded adjusted hazard ratios for the composite endpoint that were significantly higher in patients in the high MPV tertile (>8.8 fl) (HR 1.6, 95%CI=1.1- 2.5, P=0.04). We conclude that high MPV was associated with an increased risk of death and ACS among patients with chest pain who were discharged from internal medicine wards.

Departments of aCardiology

bInternal Medicine C

cInternal Medicine B, Meir Medical Center, Kfar Saba

dInstitute of Hematology, Davidoff Cancer Center, Beilinson Hospital, Rabin Medical Center, Petah Tikva

eSackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

* Gil Beeri and Guy Topaz contributed equally to the writing of this article.

Received 15 November 2018 Revised 20 April 2019 Accepted 24 April 2019

Correspondence to David Pereg, MD, Cardiology Division, Meir Medical Center, 59 Tchernichovsky St, Kfar Saba 44281, Israel, Tel: + 972 9747 2587; fax: + 972 9747 2812; e-mail: davidpe@post.tau.ac.il

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