Abstract 14785: Mean Platelet Volume is an Independent Predictor of Left Ventricular Systolic Dysfunction and is Associated with Adverse Cardiovascular Outcomes

Abstract

Background: Mean Platelet Volume (MPV) is a readily available estimate of platelet size in circulating blood and may be a marker of cardiovascular (CV) risk. We hypothesized that an elevated MPV is a predictor of a) left ventricular systolic dysfunction (LVSD) and b) future adverse CV outcomes.

Methods: We studied 2637 patients undergoing coronary angiography who were enrolled in the Emory Cardiovascular Biobank (age 63 ± 12 yrs, 73% male). LVSD was defined as an ejection fraction of <40%. Patients were followed for a mean period of 2.1 ± 1.1 yrs for the primary combined endpoint of death, myocardial infarction, or revascularization. Multivariate logistic regression models and Kaplan Meier survival analyses were performed.

Results: Mean MPV was 8.4 ± 1.0 fL. Patients presenting with LVSD (n=376) had higher MPV levels (8.6 vs. 8.4; p= 4.9 x 10^-4) than patients without LVSD. With each unit (fL) increase in MPV levels there was a 23% increased risk in presence of LVSD [OR 1.23, p=0.003] after adjustment for age, gender, body mass index, anemia, platelet count, acute myocardial infarction, hypertension, diabetes, smoking, presence and severity of CAD, use of aspirin and clopidogrel. In Kaplan Meier survival analysis, patients with elevated MPV levels (≥ 9.8 fL ROC cutoff value) had increased risk of adverse CV events in comparison to patients with lower MPV levels in the entire cohort (log rank p=0.03)(figure). There was a significant interaction between MPV levels and LVSD (p=0.035). Elevated MPV levels only increased the risk of adverse CV events in the subset of patients with LVSD (p=0.031).

Conclusion: Patients with LVSD have higher MPV levels. An elevated MPV is associated with future adverse CV outcomes in patients with left ventricular systolic dysfunction. Mechanisms underlying changes in MPV require further studies.