Buradasınız

Ortalama Trombosit Hacmi; Akut ST Elevasyonlu Miyokard Enfarktüsünde İnfarkt Büyüklüğünün Öngördürücüsü Değildir

Mean Platelet Volume could not Predict Infarct Size in Patients with Acute ST Elevation Myocardial Infarct

Journal Name:

Publication Year:

DOI: 
http://dx.doi.org/10.5505/abantmedj.2012.49369
Abstract (2. Language): 
Background: Increased mean platelet volume has been shown to associate with acute coronary syndromes. Aim of this study, to investigate the relationship between scinti-graphic infarct size and mean platelet volume after acute ST elevation myocardial infarction (STEMI), which has not been studied with imaging tools. Method: Fifth-four patients with acute STEMI (31 patients with anterior and 23 patients with inferior) were included in the study who were performed single photon emission computed tomography (SPECT). In all cases, venous periph-eral blood samples for hematologic and biochemical meas-urements were drawn. Platelet count, mean platelet vol-ume, creatine kinase-myocardial band protein (CKMB pro-tein), and cardiac troponin (cTnT) were obtained at admis-sion and daily during the first 72 h after a patient’s arrival by laboratory record. The severity scores of infarct size were calculated by SPECT. Results: Peak CKMB-protein, peak cTnT were positively correlated with, scintigraphic infarct size but mean platelet volume was not correlated with scintigraphic infarct size (P=0,021, P<0,0001, P=0,839 respectively). Conclusion: Our study suggests that there is no direct rela-tionship between mean platelet volume and myocardial infarct size. Thus, mean platelet volume does not predict of infarct size.
Abstract (Original Language): 
Amaç: Artmış ortalama trombosit hacmi ile akut koroner sendrom arasındaki ilişki bilinmektedir. Bu çalışmada ST elevasyonlu miyokard infarktüsü (STEMI) ile başvuran hasta-larda sintigrafik olarak tespit edilen infarkt büyüklüğü ile ortalama trombosit hacmi arasındaki ilişkinin belirlenmesi amaçlanmıştır. Yöntem: : Akut ST elevasyonlu MI ile hastaneye kabul edilen ve hastane kayıtlarından SPECT analizi olan 54 hasta ( 31 adet Anterior MI, 23 adet İnferior MI ) çalışmaya dahil edildi. Hastaların başvuru anında ve 24, 48, 72 saat sonrasında periferik venöz kandan alınan serum örnekleri ile hemogram, serum kardiyak kreatin kinaz miyokardiyal band ( CK-MB ) ve troponin T ( cTnT ) düzeyleri laboratuar kayıtlarından elde edildi. Trombosit sayısı, ortalama trombosit hacmi ve kardi-yak enzim düzeyleri kaydedildi. Miyokardiyal nekroz alanının büyüklüğü SPECT analizi ile hesaplandı. Bulgular: Pik CK-MB ve cTnT düzeyleri (örnek alınan her üç gün için aynı sonuç geçerli olmak üzere) sintigrafik infarkt alanı ile pozitif ilişkili iken, ortalama trombosit hacmi ile ilişkili bulunmadı (P=0,021, P<0,0001, P=0,839, sırasıyla). Sonuç: Bu araştırma ST elevasyonlu MI sonrası infarkt bü-yüklüğünü ile ortalama trombosit hacmi arasında ilişki olma-dığını ortaya koymaktadır. Böylelikle ortalama trombosit hacminin infarkt alanı büyüklüğünün bir öngördürücüsü olmadığı görülmektedir.
120-124

REFERENCES

References: 

1. Van der Loo B, Martin JF. A role for changes in plate-let production in the cause of acute coronary syn-dromes. Arterioscler Thromb Vasc Biol 1999;19:672-9.
2. Huczek Z, Kochman J, Filipiak KJ, Horszczaruk GJ, Grabowski M, Piatkowski R, et al. Mean platelet vol-ume on admission predicts impaired reperfusion and longterm mortality in acute myocardial infarction treated with primary percutaneous coronary inter-vention. J Am Coll Cardiol 2005;46:284-90.
3. Martin JF, Bath PM, Burr ML. Influence of platelet size on outcome after myocardial infarction. Lancet 1991; 338:1409-11.
4. Pabón Osuna P, Nieto Ballesteros F, Moríñigo Muñoz JL, Sánchez Fernández PL, Arribas Jiménez A, Diego Domínguez M, et al. The effect of the mean platelet volume on the short-term prognosis of acute myo-cardial infarct. Rev Esp Cardiol 1998;51:816-22. [Ab-stract]
5. Slomka PJ, Fieno D, Thomson L, Friedman JD, Hayes SW, Germano G, Berman DS. Automatic detection and size quantification of infarcts by myocardial per-fusion SPECT: clinical validation by delayed-enhancement MRI. J Nucl Med 2005; 46:728–735.
6. Chouraqui P, Livschitz S, Baron J, Moalem I, Shechter M. The assessment of infarct size in postmyocardial infarction patients undergoing thallium-201 tomo-
graphic imaging is improved using attenuation cor-rection. Clin Nucl Med 2004; 29: 352-7.
7. De Sutter J, Van de Wiele C, D'Asseler Y, De Bondt P, De Backer G, Rigo P, Dierckx R. Automatic quantifica-tion of defect size using normal templates: a com-parative clinical study of three commercially availa-ble algorithms. Eur J Nucl Med 2000; 27: 1827-34.
8. Maddahi J, Van Train K, Prigent F, Garcia EV, Fried-man J, Ostrzega E, Berman D. Quantitative single photon emission computed thallium-201 tomogra-phy for detection and localization of oronary artery disease: optimization and prospective validation of a new technique. J Am Coll Cardiol 1989; 14: 1689–1699.
9. Cloninger KG, DePuey EG, Garcia EV, Roubin GS, Robbins WL, Nody A, DePasquale EE, Berger HJ. In-complete redistribution in delayed thallium-201 sin-gle photon emission computed tomographic (SPECT) images: an overestimation of myocardial scarring. J Am Coll Cardiol 1988; 12:955–963.
10. Gibbons RJ, Valeti US, Araoz PA, Jaffe AS. The quanti-fication of infarct size. J Am Coll Cardiol 2004; 44:1533–1542.
11. Tzivoni D, Koukoui D, Guetta V, Novack L, Cowing G. Comparison ofTroponin T to creatine kinase and to radionuclide cardiac imaging infarct sizein patients with ST-elevation myocardial infarction undergoing primary angioplasty. Am J Cardiol 2008; 101:753–757.
12. Villanueva FS, Glasheen WP, Sklenar J, Kaul S. Char-acterization of spatial patterns of flow within the reperfused myocardium by myocardial contrast echocardiography. Implications in determining ex-tent of myocardial salvage. Circulation. 1993;88:2596–2606.
13. Kaul S. Myocardial contrast echocardiography: 15 years of research and development. Circulation. 1997;96:3745–3760.
14. Simonetti OP, Kim RJ, Fieno DS, Hillenbrand HB, Wu E, Bundy JM, Finn JP, Judd RM. An improved MR im-aging technique for the visualization of myocardial infarction. Radiology.2001;218:215–223.
15. Mahrholdt H, Wagner A, Judd RM, Sechtem U. As-sessment of myocardial viability by cardiovascular magnetic resonance imaging. Eur Heart J. 2002;23:602–619.
16. Kishk YT, Trowbridge EA, Martin JF. Platelet volume subpopulations in acute myocardial infarction: an in-vestigation of their homogeneity for smoking, infarct size and site. Clin Sci 1985: 68:419–425
17. Pereg D, Berlin T, Mosseri M. Mean platelet volume on admission correlates with impaired response to thrombolysis in patients with ST-elevation myocardi-al infarction. Platelets. 2010;21:117-21.
18. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, Mohler ER, Reilly MP, Berger JS. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8:148-56.
19. Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B, Mohler ER, Reilly MP, Berger JS. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010; 8: 148–56.

Thank you for copying data from http://www.arastirmax.com