Abstract 10837: Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio on Admission as a Predictor of Impaired Reperfusion in Patients Presenting with ST-Segment Elevation Myocardial Infarction
Background: Mean platelet volume (MPV) and Neutrophil-to-Lymphocyte ratio (NLR) have been reported to be associated with worse outcomes in patients with ST-segment elevation myocardial infarction (STEMI). However, their combined effect on coronary flow post primary percutaneous coronary intervention (PCI) has never been studied.
Methods: Data from the Montefiore Medical Center STEMI registry were analyzed to evaluate the association of MPV and NLR values on presentation and coronary flow post primary PCI. Corrected TIMI frame counts (cTFC) were measured and abnormal flow was defined as a cTFC >28. MPV and NLR were analyzed as tertiles and the highest tertile was compared with the 1st and 2nd tertiles combined. Multiple logistic regression was used to adjust for all available demographic, clinical, laboratory and angiographic data.
Results: We included a total of 181 consecutive patients presenting with STEMI from January 1, 2010 to January 1, 2011. On average, patients were 60 years old, 30% women, and 49% non-white. Both high MPV (adjusted odds ratio [OR]: 3.91, 95% confidence interval [CI]: 1.29 - 11.84) as well as high NLR (adjusted OR: 3.82, 95% CI: 1.19-12.31) were independently associated with abnormal coronary flow post PCI. Furthermore, there was a significant interaction between MPV and NLR (p=0.03) and patients with high MPV and high NLR had the highest incidence of abnormal post PCI coronary flow, whereas the lowest incidence of abnormal post PCI coronary flow was seen in patients with low MPV and low NLR. Both increasing MPV and NLR were associated with worsening coronary flow but these associations were not noted to be independent or additive.
Conclusions: Both high MPV and high NLR on presentation were noted to be associated with worse coronary flow post primary PCI which may explain their previously demonstrated association with worse outcomes. Further work is needed to better elucidate their prognostic utility and impact on long term outcomes.
- © 2011 by American Heart Association, Inc.