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Hajimoradi B, Hosseini B, Alirezaei T, Pourmotahari F. 25-Hydroxy vitamin D level is associated with mean platelet volume in patients with acute coronary syndrome. Cardiovasc Hematol Disord Drug Targets 2022; 22:CHDDT-EPUB-122649. [PMID: 35440329 DOI: 10.2174/1871529x22666220418111905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/15/2021] [Accepted: 01/15/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIMS A better identification of the role of vitamin D in the thrombotic process of acute coronary syndrome (ACS) will help increase the therapeutic options for this important clinical condition. There is little published evidence that 25-hydroxy vitamin D (25(OH)D) serum levels can associate with platelet function and risk of thrombosis. MATERIALS AND METHODS This prospective study was conducted on 200 patients with a diagnosis of ACS, including patients with unstable angina (UA), non-ST segment elevation myocardial infarction (NSTEMI), and ST segment elevation myocardial infarction (STEMI). In addition to demographics and angiographic data, serum concentrations of 25(OH)D and MPV were recorded in all patients. RESULTS The types of ACS were STEMI (35%), NSTEMI (25%), and UA (40%). The concentrations of 25(OH)D in patients with UA, NSTEMI, and STEMI were 23.53 ± 13.26, 19.25 ± 8.09 and 14.60 ± 8.24 ng/mL respectively (P < 0.001), and the values of MPV were 9.83 ± 1.35, 10.30 ± 1.21, and 11.56 ± 1.38 fL, respectively (P < 0.001). There was a negative correlation between 25(OH)D and MPV (R = -0.320, P < 0.0001). ROC analysis illustrated a moderate predictive value (AUC 0.706; 95% CI, 0.63-0.72) in identifying the discrimination threshold of MPV (≥ 9.90 fL) for vitamin D deficiency (<20 ng/mL). CONCLUSION The current study shows an inverse association between MPV and vitamin D levels in ACS patients, especially in the subgroup of STEMI. These findings propose the effect of vitamin D on platelet size and function, suggesting its role in thrombosis and hemostasis, which might explain the link between vitamin D deficiency and cardiovascular diseases.
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Affiliation(s)
- Behzad Hajimoradi
- Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science
| | - Behnaz Hosseini
- Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science
| | - Toktam Alirezaei
- Shohada Tajrish Hospital, Shahid Beheshti University of Medical Science
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Differential Diagnosis of Stroke by Platelet Large Cell Ratio (P-LCR) Levels. JOURNAL OF CONTEMPORARY MEDICINE 2021. [DOI: 10.16899/jcm.867170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Luke K, Purwanto B, Herawati L, Al-Farabi MJ, Oktaviono YH. Predictive Value of Hematologic Indices in the Diagnosis of Acute Coronary Syndrome. Open Access Maced J Med Sci 2019; 7:2428-2433. [PMID: 31666841 PMCID: PMC6814467 DOI: 10.3889/oamjms.2019.666] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND: Distinguishing between Acute Coronary Syndrom (ACS) and SCAD (Stable Coronary Artery Disease) requires advanced laboratory instrument and electrocardiogram. However, their availabilities in primary care settings in developing countries are limited. Hematologic changes usually occur in the ACS patient and might be valuable to distinguish ACS from SCAD. AIM: This study compares the hematologic indices between ACS and SCAD patients and analyses its predictive value for ACS. MATERIAL AND METHODS: A total of 191 patients (79 ACS and 112 SCAD) were enrolled in this study based on the inclusion criteria. Patient’s characteristic, hematologic indices on admission, and the final diagnosis were obtained from medical records. Statistical analyses were done using SPSS 23.0. RESULTS: In this research MCHC value (33.40 vs. 32.80 g/dL; p < 0.05); WBC (11.16 vs. 7.40 x109/L; p < 0.001); NLR (6.29 vs. 2.18; p < 0.001); and PLR (173.88 vs 122.46; p < 0.001) were significantly higher in ACS compared to SCAD patients. While MPV (6.40 vs. 10.00 fL; p < 0.001) was significantly lower in ACS patients. ROC curve analysis showed MPV had the highest AUC (95%) for ACS diagnosis with an optimum cut-off point at ≤ 8.35 fL (sensitivity 93.6% and specificity 97.3%). CONCLUSION: There was a significant difference between hematologic indices between ACS and SCAD patients. MPV is the best indices to distinguish ACS.
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Affiliation(s)
- Kevin Luke
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bambang Purwanto
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Lilik Herawati
- Department of Physiology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.,School of Management, Healthcare Entrepreneurship Division, University College London, Gower St, Bloomsbury, WC1E 6BT, London, UK
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Alvitigala BY, Azra MAF, Kottahachchi DU, Jayasekera MMPT, Wijesinghe RANK. A study of association between platelet volume indices and ST elevation myocardial infarction. IJC HEART & VASCULATURE 2018; 21:7-10. [PMID: 30211294 PMCID: PMC6134176 DOI: 10.1016/j.ijcha.2018.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/01/2018] [Accepted: 09/04/2018] [Indexed: 11/25/2022]
Abstract
Introduction and objective ST elevation myocardial infarction (STEMI) is caused by formation of a thrombus at a ruptured atheromatous plaque. Larger platelets are enzymatically and metabolically more active and play a crucial role in thrombus formation. Our objective was to study the association between platelet volume indices (mean platelet volume (MPV) and platelet distribution width (PDW)) and STEMI. Methods A hospital-based case control study to compare the platelet indices of 52 STEMI patients before commencing antiplatelet therapy and age and gender matched 52 controls who had no history of ischemic heart disease or antiplatelet therapy. Blood samples were collected to EDTA bottles and analyzed using Mindray BC 6800 automated analyzer. Results STEMI patients had significantly increased mean MPV and PDW compared to the control group ((8.22 ± 0.99 fL vs 7.74 ± 0.69 fL, p = 0.005) and (15.81 ± 0.41 fL vs 15.62 ± 0.33 fL, p = 0.007) respectively). Significant positive correlation existed between MPV and PDW (R = 0.556, p = 0.000) and weak negative correlation in platelet count with MPV (R = -0.323, p = 0.019) and PDW (R = -0.309, p = 0.026) of STEMI patients. Receiver Operating Characteristic (ROC) curves showed that MPV and PDW with cutoff values of 7.55 fL, 15.55 fL and with Area under the curve (AUC) of 0.640, 0.620 respectively. The sensitivities and specificities were found to be 73.1%, 69.2% and 61.5%, 55.8% for MPV and PDW respectively. Conclusion Increased MPV and PDW were found to have a significant association with STEMI and this test has the potential to be used as a preliminary test to identify high-risk patient for myocardial infarction.
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Affiliation(s)
- Bhawani Yasassri Alvitigala
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka
| | - Mohammedu Aroos Fathima Azra
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka
| | - Darshana Udakara Kottahachchi
- Department of Medical Laboratory Sciences, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Sri Lanka
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Prognostic value of hematological parameters in patients with acute myocardial infarction: Intrahospital outcomes. PLoS One 2018; 13:e0194897. [PMID: 29668734 PMCID: PMC5905886 DOI: 10.1371/journal.pone.0194897] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 03/12/2018] [Indexed: 01/16/2023] Open
Abstract
Background The intensity of the inflammatory response and hemodynamic repercussion in acute myocardial infarction causing the presence in the peripheral circulation of nucleated red blood cells (NRBCs), increases in mean platelet volume (MPV) and neutrophil to lymphocyte ratio (NLR) are associated with a poorer prognosis. The aim of this study was to assess the role of these hematological biomarkers as predictors of all causes of mortality during the hospitalization of patients with acute myocardial infarction. Methods Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio were measured daily during the hospitalization of the patients with acute myocardial infarction. We excluded patients younger than 18 years, on glucocorticoid therapy, with cancer or hematological diseases and those that were readmitted after hospital discharge. We performed a multiple logistic analysis to identify independent predictors of mortality. Results We included 466 patients (mean age 64.2 ± 12.8 years, 61.6% male). The prevalence of NRBCs in the sample was 9.1% (42 patients), with levels > 200/μL in 27 patients (5.8%). The mean MPV value was 10.9 ±0,9 and the mean NLR value was 3.71 (2,38; 5,72). In a multivariate analysis of serum NRBCs (HR 2.42, 95% CI: 1.35–4.36, p = 0.003), MPV (HR 2.97, 95% CI: 1.15–7.67, p = 0.024) and NLR (HR 5.02, 95% CI: 1.68–15.0, p = 0.004). The presence in the peripheral blood of NRBCs, increased in mean platelet volume and neutrophil to lymphocyte ratio were associated with higher mortality. Conclusions Nucleated red blood cells, mean platelet volume and neutrophil to lymphocyte ratio are independent predictors of intrahospital mortality. Therefore, an important tool in intrahospital clinical surveillance.
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梁 琦, 雷 新, 李 红, 殷 艳, 任 洁, 范 力, 黄 欣, 袁 祖. [Regression analysis of red cell distribution width and mean platelet volume in patients with acute myocardial infarction]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2017; 37:1022-1027. [PMID: 28801280 PMCID: PMC6765727 DOI: 10.3969/j.issn.1673-4254.2017.08.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate clinical implications of changes in red cell distribution width (RDW) and mean platelet volume (MPV) in patients with acute myocardial infarction. METHODS A total of 127 patients (90 men and 37 women) were enrolled in this analysis, including 66 with acute myocardial infarction (AMI) and 61 with unstable angina (UA). The patients' baseline demographic and clinical data were compared between the two groups including age, hypertension, diabetes, smoking, BMI, blood biochemical profiles, cardiac functions and platelet and red blood cell parameters. The patients were further divided into subgroups according to the RDW 50% cumulative frequency, and the MPV, P-LCR, hsCRP, NT-proBNP, RBC, Dimer and MCV were compared. The correlations between platelet and erythrocyte test results were evaluated in both the AMI and UA patients. Regression analysis was performed to identify the factors affecting the RDW in the AMI group and a regression model was established. RESULTS The platelet and red blood cell test results, P-LCR, MPV, and RDW differed significantly between AMI and UA groups (P<0.01 or 0.05). Correlation analysis showed a significant positive correlation between RDW and MPV in AMI group (r=0.34, P<0.01). Between the subgroups with different RDW 50% cumulative frequencies, MPV, P-LCR, hsCRP, D-Dimer, and NT-proBNP all differed significantly (P<0.05 or 0.01). In AMI group, with RDW as the dependent variable, we established a multivariate regression model of RDW=0.19MPV+10.83. CONCLUSION RDW and MPV are closely correlated in patients with AMI. In multiple regression analysis, MPV can explain the changes in RDW in patients with AMI.
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Affiliation(s)
- 琦 梁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 新军 雷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 红兵 李
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 艳蓉 殷
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 洁 任
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 力宏 范
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 欣 黄
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
| | - 祖贻 袁
- />西安交通大学医学院第一附属医院心血管内科, 陕西 西安 710061Department of Cardiology, First Affiliate Hospital of Xi'an Jiaotong University College of Medicine, Xi'an 710061, China
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Amraotkar AR, Song DD, Otero D, Trainor PJ, Ismail I, Kothari V, Singh A, Moore JB, Rai SN, DeFilippis AP. Platelet Count and Mean Platelet Volume at the Time of and After Acute Myocardial Infarction. Clin Appl Thromb Hemost 2016; 23:1052-1059. [PMID: 28294633 DOI: 10.1177/1076029616683804] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Platelet count has been shown to be lower and mean platelet volume (MPV) to be higher in acute myocardial infarction (MI). However, it is not known whether these changes persist post-MI or if these measures are able to distinguish between acute thrombotic and non-thrombotic MI. Platelet count and MPV were measured in 80 subjects with acute MI (thrombotic and non-thrombotic) and stable coronary artery disease (CAD) at cardiac catheterization (acute phase) and at >3-month follow-up (quiescent phase). Subjects were stratified using stringent clinical, biochemical, histological, and angiographic criteria. Outcome measures were compared between groups by analysis of variance. Forty-seven subjects met criteria for acute MI with clearly defined thrombotic (n = 22) and non-thrombotic (n = 12) subsets. Fourteen subjects met criteria for stable CAD. No significant difference was observed in platelet count between subjects with acute MI and stable CAD at the acute or quiescent phase. MPV was higher in acute MI (9.18 ± 1.21) compared to stable CAD (8.13 ± 0.66; P = 0.003) at the acute phase but not at the quiescent phase (8.48 ± 0.58 vs 8.94 ± 1.42; P = 0.19). No difference in platelet count or MPV was detected between thrombotic and non-thrombotic subsets at acute or quiescent phases. The power to detect differences in these measures between thrombotic and non-thrombotic subsets was 58%. Higher MPV at the time of acute MI is not observed by 3 months post-MI (quiescent phase). Platelet count and MPV do not differ in subjects with thrombotic versus non-thrombotic MI. Further investigation is warranted to evaluate the utility of these measures in the diagnosis of acute MI.
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Affiliation(s)
| | - David Day Song
- 2 School of Medicine, University of Louisville, Louisville, KY, USA
| | - Diana Otero
- 3 Bronx Program, Icahn School of Medicine at Mount Sinai, Bronx, NY, USA
| | - Patrick James Trainor
- 1 Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.,4 Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA
| | - Imtiaz Ismail
- 5 Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Vallari Kothari
- 6 Department of Internal Medicine, Henry Ford Hospital, Detroit, MI, USA
| | - Ayesha Singh
- 2 School of Medicine, University of Louisville, Louisville, KY, USA
| | - Joseph B Moore
- 1 Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA
| | - Shesh Nath Rai
- 5 Department of Medicine, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.,7 Biostatistics Shared Facility, J. G. Brown Cancer Center, University of Louisville, Louisville, KY, USA
| | - Andrew Paul DeFilippis
- 1 Division of Cardiovascular Medicine, University of Louisville, Louisville, KY, USA.,8 KentuckyOne Health Jewish Hospital, Louisville, KY, USA.,9 Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD, USA
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Rezaei Y, Hosseini S, Samiei N. Which leukocyte subtypes can predict outcomes of acute coronary syndrome? Atherosclerosis 2016; 255:217-218. [PMID: 27614401 DOI: 10.1016/j.atherosclerosis.2016.08.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 08/31/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Yousef Rezaei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Saeid Hosseini
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Niloufar Samiei
- Heart Valve Disease Research Center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Alhusseiny AH, Al-Nimer MSM, Mohammad FI, Ali Jadoo SA. Concomitant measurements of serum annexin A5 levels and hematological indices as markers in recent and old myocardial infarction with low ejection fraction: A preliminary study. Int J Cardiol 2016; 223:514-518. [PMID: 27552568 DOI: 10.1016/j.ijcard.2016.08.244] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 08/10/2016] [Accepted: 08/12/2016] [Indexed: 12/17/2022]
Abstract
BACKGROUND Serum annexin A5 (anxA5) level is significantly increased in patients with acute coronary syndrome. Hematological indices are significantly increased in patients with ischemic heart disease. This study aimed to demonstrate the changes in the distribution of blood cells and the levels of anxA5 in patients presented with significant low ejection fraction ST-elevation acute myocardial infarction (STEMI) in comparison with corresponding patients with ischemic heart disease. METHODS Patients with low ejection fraction presenting at Hospital of Diyala University of Iraq were enrolled. Electrocardiograph (ECG), echocardiograph, hematological indices, serum annexin V (anxV) levels and the determinants of the cardio-metabolic risk factors were performed. Based on clinical examination, ECG findings and laboratory tests, patients were divided into healthy subjects (n=20); patients with acute MI (n=40) and with chronic MI (n=12). RESULTS Acute MI has significant high levels of serum triglyceride, uric acid and high mean value of red cell distribution width (RDW) compared with healthy subjects and chronic MI. Platelet distribution width (PDW) is significantly reduced in patients of acute MI and chronic MI compared with healthy subjects, whereas the plateletcrit (PCT) is significantly higher in acute MI compared with healthy subjects. There is an insignificant difference between the means of serum anxA5 levels of acute MI (35.6±7.2ng/ml) and chronic MI (32.4±8.9ng/ml), but significantly higher than the cutoff level of the healthy subjects (5ng/ml). CONCLUSIONS Measurement of serum annexin level is a useful diagnostic marker of acute or chronic MI with low ejection fraction.
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Affiliation(s)
| | - Marwan S M Al-Nimer
- Department of Pharmacology, College of Medicine, Al-Mustansiriya University, Baghdad, Iraq
| | | | - Saad Ahmed Ali Jadoo
- International Centre for Casemix and Clinical coding, National University of Malaysia Kuala Lumpur, Malaysia.
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Mean platelet volume in young children with urinary tract infection. Sci Rep 2015; 5:18072. [PMID: 26666588 PMCID: PMC4678298 DOI: 10.1038/srep18072] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/10/2015] [Indexed: 12/20/2022] Open
Abstract
Mean platelet volume (MPV) has not yet been well-established in urinary tract infection (UTI). The purpose of this study was to evaluate the role of MPV as an acute phase reactant in children with UTI. Data from 118 young children (<2 years) with UTI between 2012 and 2013 were grouped as acute pyelonephritis (APN) and lower UTI according to the dimercaptosuccinic acid (DMSA) scan abnormalities. MPV, platelet distribution width (PDW) platelet count, and other infection markers (white blood cell [WBC] count, erythrocyte sedimentation rate [ESR], and C-reactive protein [CRP]) were measured. WBC (P = 0.001), ESR (P = 0.005), CRP (P < 0.001) and MPV levels (P = 0.011) were significantly higher in the APN group than those in the lower UTI group. MPV positively correlated with PDW, CRP and negatively with platelet count. Multiple logistic regression analyses showed that CRP and MPV were independent predictive factors for APN patients. However, the area under the Receiver Operating Characteristic (ROC) curve analysis for MPV was lower than CRP. Our results suggest that MPV can be an inflammatory marker in UTI, but the predictive value of MPV was not superior to CRP in the diagnosis of APN.
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Mean platelet volume in acute coronary syndrome. Indian Heart J 2015; 67:409-10. [PMID: 26304583 DOI: 10.1016/j.ihj.2015.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Revised: 05/02/2015] [Accepted: 05/14/2015] [Indexed: 11/21/2022] Open
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