Abstract 11814: Platelet Distribution Width as a Novel Prognostic Marker in Chronic Heart Failure
Background: Chronic heart failure (CHF) is associated with increased risk of cardiovascular thromboembolism and sudden death. This may be related to abnormalities of thrombogenesis and platelet activation. The mean platelet volume (MPV) and the platelet distribution width (PDW) are the most extensively studied platelet activation marker. Although these platelet parameters have been routinely and widely available to clinicians, their role in patients with CHF remains poorly defined. We hypothesised that CHF patients would show greater abnormalities in platelet indices due to platelet swelling and pseudoponia formation. Moreover, we examined whether MPV and/or PDW is a risk factor for CHF patients.
Methods and Results: We measured platelet structural indices MPV and PDW in 205 patients with CHF and 54 controls. There were significant differences between CHF and control in MPV (9.0 ± 0.9 vs. 9.6 ± 1.4, p = 0.0007) and PDW (15.8 ± 0.6 vs. 14.3 ± 1.9, p < 0.0001). The primary end-point was cardiovascular events and mortality CHF. Sixty-eight patients had cardiac events during the follow-up period (median 772 days). Multivariate Cox proportional hazard analysis demonstrated that PDW independently predicted cardiac events (hazard ratio 1.576, p < 0.05). However, platelet counts and MPV could not predict cardiac events. PDW categorized into quartile because the normal range for PDW in CHF patients has not been established. Kaplan-Meier analysis demonstrated that cardiac event rates were significantly increased from the first to the fourth quartile (Figure).
Conclusion: Platelet overactivation was frequently observed in CHF patients. Platelet overactivation may partly associate with the pathophysiology of adverse complications in CHF. PDW may be a novel and feasible prognostic marker for CHF patients.
- © 2011 by American Heart Association, Inc.