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Journal of Diabetes and its Complications

SeptemberOctober 2014, Vol.28(5):652657, doi:10.1016/j.jdiacomp.2014.05.002
Prognostic significance of mean platelet volume in diabetic patients with ST-elevation myocardial
infarctionAndrzej LekstonBartosz HudzikLech Polonski
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AbstractPurpose
Mean platelet volume (MPV) is a universally available parameter with routine blood counts. It has
been linked to many cardiovascular risk factors. MPV is a marker of platelet size and activity and
has been linked to poor prognosis following STEMI. There has been an increasing number of
reports linking diabetes mellitus (DM) to platelet dysfunction. The aim of the study was to
examine the association between admission MPV and clinical outcomes in patients with DM and
STEMI undergoing primary percutaneous coronary intervention (PCI). The secondary objective of
the study was to evaluate whether this index can be used to determine the long-term prognosis.
Methods
A total of 1,557 patients with STEMI undergoing primary PCI were enrolled and divided into two
groups depending on their diabetes mellitus status: Group 1 patients with diabetes mellitus (N
= 539) and Group 2 patients without diabetes mellitus (N = 1018).
Results
MPV and peak CK-MB concentration were higher in diabetic patients as compared to non-diabetic
patients. In diabetic patients, MPV was positively correlated with admission Killip class and
negatively correlated with time to death during follow-up, initial TIMI flow, final TIMI flow, and
erythrocyte count. In non-diabetic patients, MPV was positively correlated with the number of
diseased coronary arteries, admission Killip class, and negatively correlated with time to death
during follow-up and initial TIMI flow. ROC analysis revealed high diagnostic value of MPV in
predicting in-hospital and one-year mortality. MPV cut-off level was lower for diabetic patients
compared to non-diabetic patients.
Conclusions
Diabetic patients had higher MPV than non-diabetic patients. Both in diabetic and non-diabetic
patients MPV proved to have good prognostic value for in-hospital and late mortality. MPV cut-

off value for predicting mortality was lower in diabetic patients. Mortality rate was the highest in
the fourth quartiles of MPV in both study groups.
KeywordsMean platelet volumeDiabetes mellitusMyocardial infarctionPercutaneous coronary
interventionPrognosis
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Conflict of interest: The authors declare that they have no conflict of interest.

Corresponding author at: Third Department of Cardiology, Medical University of Silesia, Silesian
Center for Heart Disease, Curie-Sklodowska 9, 41-800 Zabrze, POLAND. Tel.: + 48 32 3733788;
fax: + 48 32 2732679.
Copyright 2014 Elsevier Inc. All rights reserved.