Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Autor: Samad Ghaffari, Nashmil Parvizian, Leili Pourafkari, Ahmad Separham, Reza Hajizadeh, Nader D Nader, Elnaz Javanshir, Nariman Sepehrvand, Arezou Tajlil, Babak Nasiri
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Journal of Cardiovascular and Thoracic Research, Vol 12, Iss 1, Pp 56-62 (2020)
Druh dokumentu: article
ISSN: 2008-5117
2008-6830
DOI: 10.34172/jcvtr.2020.09
Popis: Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P = 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes.
Databáze: Directory of Open Access Journals
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