Comparison of prognostic significance of mean platelet volume/platelet count with GRACE for long-term prognosis in patients with non-ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention.

BACKGROUND: Mean platelet volume to platelet count ratio (MPV/P ratio) has been demonstrated to be a predictor of adverse outcome in patients with non-ST-segment elevation myocardial infarction (NSTEMI). We aimed to assess whether MPV/P ratio is a useful marker to predict long-term prognosis in NSTEMI patients undergoing PCI. Moreover, the prognostic accuracy of MPV/P ratio was compared with MPV and GRACE score.

METHODS: In a retrospective cohort study, according to the baseline MPV/P values, 887 consecutive NSTEMI patients undergoing PCI were divided into two groups: the high MPV/P group (n=296, MPV/P ≥0.054) and the low MPV/P group (n=591, MPV/P<0.054). Clinical endpoints were all-cause mortality and all-cause mortality/nonfatal reinfarction.

RESULTS: Multivariate analysis showed that high MPV/P was an independent predictor of all-cause mortality [HRs: 1.973, 95% CI: 1.528-2.549, P<0.001], and all-cause mortality/nonfatal myocardial reinfarction [HRs: 1.289, 95% CI: 1.181-1.408, P<0.001]. MPV/P ratio has good accuracy for predicting clinical endpoints. The discriminatory performance of MPV/P ratio was similar to GRACE score but better than MPV (for all-cause mortality: MPV/P vs. GRACE: z=0.205, p=0.837; MPV/P vs. MPV: z=2.677, p=0.008; GRACE vs. MPV: z=3.017, p=0.003; for all-cause mortality/nonfatal myocardial: MPV/P vs. GRACE: z=1.098, p=0.272; MPV/P vs. MPV: z=4.026, p<0.001; GRACE vs. MPV: z=4.962, p<0.001).

CONCLUSIONS: MPV/P ratio was similar to GRACE score but better than MPV for predicting all-cause mortality and all-cause mortality/nonfatal myocardial reinfarction in NSTEMI patients undergoing PCI. However, MPV/P ratio is easier to calculate than GRACE score.