Usefulness of platelet mass index in the prediction of angiographic no-reflow in patients with acute ST-segment elevation myocardial infarction.

Abstract

Background and objective: No-reflow phenomenon (NR) is a serious complication with increased morbidity and mortality in percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction (STEMI). Studies on the relationship between the NR and mean platelet volume (MPV) and platelet count (PLT) are controversial. Platelet mass index (PMI) is a novel inflammation and platelet index, calculated as PLT multiplied by MPV. So, it would be prudent to assume that a high PMI is likely to be associated with NR. PMI's low cost and rapid availability may aid NR risk stratification. Our aim was to assess the relationship between PMI and no-reflow in acute STEMI patients.

Methods: A total of 212 acute STEMI patients were enrolled in this retrospective study and the patients were stratified into two subgroups as no-reflow group (n = 45) and reflow group (n = 167). Patient data regarding demographics, clinical, angiographic and laboratory parameters were retrieved from the digital hospital archives. No-reflow was defined angiographic thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2. PMI was calculated as platelet count multiplied by mean platelet volume (MPV).

Results: Mean age of the no-reflow and reflow groups was 59.3 ∓ 8.6 and 59.1 ∓ 12.6 years, respectively (p > 0.05). PMI was greater in the no-reflow group [2585(2278-3000) vs. 2054(1594-2344), respectively, p < 0.001]. PMI was correlated with WBC count (r = 0.290, p < 0.001), Hemoglobin (r=-0.281, p < 0.001), neutrophil count (p = 0.303, p < 0.001), platelet count (r = 303, p < 0.001), MPV (r = 0.195, p = 0.006), platelet distribution width (p = 0.215, r = 0.002), and PCT (r = 0.970, p < 0.001), and Syntax score-2 (r = 0.162, p = 0.024). In mulvariate logistic regression analysis, PMI [OR: 1.008(1.003-1.012), p = 0.001], age [OR: 1.111 (1.036-1.253), p = 0.007], and WBC count [OR: 0.018(0.001-0.581), p = 0.024] were independently associated with NR.

Conclusion: PMI has been a simple and readily available parameter that could be a promising indicator to estimate NR in patients with acute STEMI.