TY - JOUR
T1 - Impact of age on mean platelet volume and its relationship with coronary artery disease
T2 - A single-centre cohort study
AU - on behalf of the Novara Atherosclerosis Study (NAS) group
AU - Verdoia, Monica
AU - Schaffer, Alon
AU - Barbieri, Lucia
AU - Bellomo, Giorgio
AU - Marino, Paolo
AU - Sinigaglia, Fabiola
AU - Suryapranata, Harry
AU - De Luca, Giuseppe
N1 - Publisher Copyright:
© 2015 Elsevier Inc.
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Elderly patients represent a high risk category among subjects with atherosclerosis, due to the presence of comorbidities and suboptimal response to antiplatelet drugs. Mean platelet volume (MPV) has been indicated as a marker of platelet reactivity, with contrasting data on its role on coronary artery disease. Aim of the present study was to evaluate the impact of age on the MPV and its role on the extent of coronary artery disease (CAD). Methods: Our population is represented by a cohort of 3750 patients undergoing coronary angiography. Elderly were defined according to age. ≥. 75. years. MPV was measured at admission. Significant coronary artery disease was defined as a stenosis >. 50% in at least 1 coronary vessel, while severe CAD was defined as left main and/or three-vessel disease. Results: A total of 1170 out of 3750 (31.2%) patients were ≥. 75. years old. Advanced age was associated with female gender (p. <. 0.001), hypertension (p. <. 0.001), renal failure (p. <. 0.001), previous myocardial infarction (p = 0.03) coronary artery bypass grafting (p. <. 0.001) indication to angiography (p. <. 0.001), therapy with angiotension-receptor blockers, (p = 0.003), nitrates, diuretics and calcium-antagonists (p. <. 0.001), serum creatinine (p. <. 0.001), fibrinogen (p. <. 0.001) and C reactive protein (p = 0.02), but inversely to percutaneous coronary interventions (p = 0.02), dyslipidemia, family history of CAD and smoking (p. <. 0.001, respectively), use of statins (p = 0.02) and beta blockers (p = 0.003), haemoglobin, total cholesterol and triglycerides (p. <. 0.001, respectively), white blood cells (p = 0.009) and platelet count (p = 0.006).Elderly patients displayed a significantly larger platelet volume (p. <. 0.001), with a direct linear relationship between age and the MPV (r = 0.08, p. <. 0.001), with age being confirmed as an independent predictor of larger MPV (≥. 10.85. fl) at multivariate analysis (adjusted OR [95% CI] = 1.18 [1.01-1.40], p = 0.04).Among the elderly, MPV value above the median (≥. 10.85. fl) was not associated with a higher prevalence of coronary artery disease (77.3 vs. 79.4%, p = 0.39, adjusted OR [95% CI] = 0.94 [0.66-1.33], p = 0.71), or higher prevalence of severe CAD (35.2 vs. 32.4%, p = 0.28, adjusted OR [95% CI] = 1.34 [0.99-1.82], p = 0.06). Conclusion: Advanced age was directly associated with larger mean platelet volume that, however, did not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients.
AB - Elderly patients represent a high risk category among subjects with atherosclerosis, due to the presence of comorbidities and suboptimal response to antiplatelet drugs. Mean platelet volume (MPV) has been indicated as a marker of platelet reactivity, with contrasting data on its role on coronary artery disease. Aim of the present study was to evaluate the impact of age on the MPV and its role on the extent of coronary artery disease (CAD). Methods: Our population is represented by a cohort of 3750 patients undergoing coronary angiography. Elderly were defined according to age. ≥. 75. years. MPV was measured at admission. Significant coronary artery disease was defined as a stenosis >. 50% in at least 1 coronary vessel, while severe CAD was defined as left main and/or three-vessel disease. Results: A total of 1170 out of 3750 (31.2%) patients were ≥. 75. years old. Advanced age was associated with female gender (p. <. 0.001), hypertension (p. <. 0.001), renal failure (p. <. 0.001), previous myocardial infarction (p = 0.03) coronary artery bypass grafting (p. <. 0.001) indication to angiography (p. <. 0.001), therapy with angiotension-receptor blockers, (p = 0.003), nitrates, diuretics and calcium-antagonists (p. <. 0.001), serum creatinine (p. <. 0.001), fibrinogen (p. <. 0.001) and C reactive protein (p = 0.02), but inversely to percutaneous coronary interventions (p = 0.02), dyslipidemia, family history of CAD and smoking (p. <. 0.001, respectively), use of statins (p = 0.02) and beta blockers (p = 0.003), haemoglobin, total cholesterol and triglycerides (p. <. 0.001, respectively), white blood cells (p = 0.009) and platelet count (p = 0.006).Elderly patients displayed a significantly larger platelet volume (p. <. 0.001), with a direct linear relationship between age and the MPV (r = 0.08, p. <. 0.001), with age being confirmed as an independent predictor of larger MPV (≥. 10.85. fl) at multivariate analysis (adjusted OR [95% CI] = 1.18 [1.01-1.40], p = 0.04).Among the elderly, MPV value above the median (≥. 10.85. fl) was not associated with a higher prevalence of coronary artery disease (77.3 vs. 79.4%, p = 0.39, adjusted OR [95% CI] = 0.94 [0.66-1.33], p = 0.71), or higher prevalence of severe CAD (35.2 vs. 32.4%, p = 0.28, adjusted OR [95% CI] = 1.34 [0.99-1.82], p = 0.06). Conclusion: Advanced age was directly associated with larger mean platelet volume that, however, did not contribute to explain the higher prevalence and extent of coronary artery disease observed in elderly patients.
KW - Ageing
KW - Coronary angiography
KW - Coronary artery disease
KW - Platelet
KW - Size
UR - http://www.scopus.com/inward/record.url?scp=84920901728&partnerID=8YFLogxK
U2 - 10.1016/j.exger.2014.12.019
DO - 10.1016/j.exger.2014.12.019
M3 - Article
SN - 0531-5565
VL - 62
SP - 32
EP - 36
JO - Experimental Gerontology
JF - Experimental Gerontology
ER -