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Increased mean platelet volume associated with extent of slow coronary flow.

BACKGROUND
Slow coronary flow (SCF) is characterized by delayed opacification of epicardial coronary vessels. SCF can cause ischemia and sudden cardiac death. We investigated the association between presence and extent of SCF, and cardiovascular risk factors and hematologic indices.


METHODS
In this study, 2467 patients who received coronary angiography for suspected or known ischemic heart disease were retrospectively evaluated between April 2009 and November 2010. Following the application of exclusion criteria, our study population consisted of 57 SCF patients (experimental group) and 90 patients with age- and gender-matched subjects who proved to have normal coronary angiograms (control group). Baseline hematologic indices were measured by the automated complete blood count (CBC) analysis. The groups were evaluated for cardiovascular risk factors and medications. Patients were categorized based on the angiographic findings of vessels with or without SCF. Moreover, patients with SCF were divided into subgroups relative to the extent of SCF.


RESULTS
Among the 147 patients (mean age 52.7 ± 10.0, 53.7% male), mean platelet volume (MPV) ranged from 6.5 fL to 11.7 fL (median 7.9 fL, mean 8.1 ± 0.8 fL). Diabetes (OR = 3.64, 95% CI 1.15-10.43, p = 0.03), hypercholesterolemia (OR = 4.94, 95% CI 1.99-12.21, p = 0.001), smoking (OR = 3.54, 95% CI 1.43-8.72, p = 0.006), hemoglobin (OR = 1.69, 95% CI 1.22-2.36, p = 0.002), and MPV (OR = 2.52, 95% CI 1.43-4.44, p = 0.001) were found to be the independent correlates of SCF presence. Only MPV (OR = 2.13, 95% CI 1.05-4.33, p = 0.03) was identified as an independent correlate of extent of SCF.


CONCLUSIONS
Elevated baseline MPV value was found to be an independent predictor of the presence and extent of SCF.