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Plateletcrit

A platelet marker associated with saphenous vein graft disease

Thrombokrit

Ein mit V. saphena-Transplantat-Erkrankung zusammenhängender Thrombozytenparameter

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Abstract

Background

Saphenous vein graft disease (SVGD) after by-pass surgery is an important cause of morbidity and mortality for patients with coronary artery disease. Comprehensive evaluation of biochemical and hematological parameters associated with this problem is limited. Plateletcrit (PCT) provides complete information on total platelet mass, but it has not been previously studied. In this study, we examined the relationship between SVGD and platelet parameters such as PCT, mean platelet volume, platelet count, and platelet distribution.

Methods

We retrospectively analyzed 14,398 patients who underwent coronary angiography between February 2006 and August 2012. Records from 893 patients with previous coronary artery by-pass graft operation were re-evaluated. A total of 251 cases were divided into two groups (127 patients receiving a saphenous vein graft; 124 patients diagnosed with SVGD) and hematological and biochemical parameters were compared.

Results

There were no significant differences in clinical characteristics between the two groups except that the SVGD group had a higher median time from surgery to coronary angiography than the patent saphenous vein graft group [7 years (2–16) vs. 5 years (2–15), p < 0.001]. The SVGD groups also had significantly higher median PCT, mean platelet volume, platelet count, uric acid level, and red blood cell distribution width. The cut-off value for PCT was found to be 0.188 for predicting SVGD, with an 80.65 % sensitivity and 81.1 % specificity.

Conclusion

Plateletcrit has an important predictive value for SVGD, and it could be used as a marker for anti-platelet therapy to prevent graft atherosclerosis in patients undergoing by-pass surgery.

Zusammenfassung

Hintergrund

Die Transplantaterkrankung der V. saphena (SVGD) nach Bypass-Op. stellt eine bedeutende Ursache der Morbidität und Mortalität bei Patienten mit koronarer Herzkrankheit (KHK) dar. Eine umfassende Bewertung biochemischer und hämatologischer Parameter in Zusammenhang mit diesem Problem steht nur eingeschränkt zur Verfügung. Der Thrombokrit (PCT) liefert umfassende Informationen über das Gesamtthrombozytenvolumen, ist aber bisher nicht erforscht worden. In der vorliegenden Studie wurde die Beziehung zwischen SVGD und Thrombozytenparametern wie PCT, mittleres Thromobozytenvolumen, Thrombozytenzahl und Thrombozytenverteilung untersucht.

Methoden

Zwischen Februar 2006 und August 2012 wurden die Daten von 14.398 Patienten, bei denen eine Koronarangiographie erfolgte, retrospektiv ausgewertet. Die Krankenunterlagen von 893 Patienten mit Zustand nach Koronararterienbypass-Op. wurden noch einmal betrachtet. Insgesamt wurden 251 Fälle in 2 Gruppen eingeteilt: 127 Patienten erhielten ein V.-saphena-Transplantat, und bei 124 wurde die Diagnose einer SVGD gestellt; die hämatologischen und biochemischen Parameter wurden verglichen.

Ergebnisse

Es gab keine signifikanten Unterschiede bei den klinischen Merkmalen zwischen den beiden Gruppen bis auf die Tatsache, dass die SVGD-Gruppe eine höhere durchschnittliche Dauer von der Op. bis zur Koronarangiographie aufwies als die Gruppe mit offen gebliebenem Transplantat [7 (2–16) Jahre vs. 5 (2–15) Jahre; p < 0,001]. In der SVGD-Gruppe waren auch der mittlere PCT, das mittlere Thrombozytenvolumen, die Thrombozytenzahl, Harnsäure und Verteilungsbreite der Erythrozytenvolumina signifikant höher. Der Grenzwert für den PCT zur Vorhersage einer SVGD betrug 0,188 bei einer Sensitivität von 80,65 % und einer Spezifität von 81,1 %.

Schlussfolgerung

Der Thrombokrit ist als prädiktiver Wert für eine SVGD von Bedeutung und könnte als Marker für eine Thrombozytenaggregationshemmertherapie zur Vorbeugung der Transplantatatherosklerose bei Patienten eingesetzt werden, bei denen eine Bypass-Op. erfolgt.

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Acknowledgments

The authors thank the staff and nurse (Deniz Göven, Ahmet Tekin Şapçı, Aydan Özbay, Serpil Çutpan Boz, Anıl İncekara) for their kind and generous contributions.

Conflict of interest

On behalf of all authors, the corresponding author states that there are no conflicts of interest.

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Authors and Affiliations

  1. School of Medicine, Department of Cardiology, Bulent Ecevit University, 67600, Kozlu/Zonguldak, Turkey

    I. Akpinar, M.R. Sayin, Y.C. Gursoy, T. Karabag, E. Kucuk & M. Aydin

  2. School of Medicine, Department of Biostatistics, Bulent Ecevit University, Zonguldak, Turkey

    M.C. Buyukuysal

  3. School of Medicine, Department of Hematology, Hacettepe University, Ankara, Turkey

    I.C. Haznedaroglu

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  1. I. Akpinar
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  2. M.R. Sayin
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  3. Y.C. Gursoy
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  5. E. Kucuk
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Correspondence to I. Akpinar.

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Akpinar, I., Sayin, M., Gursoy, Y. et al. Plateletcrit. Herz 39, 142–148 (2014). https://doi.org/10.1007/s00059-013-3798-y

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  • DOI: https://doi.org/10.1007/s00059-013-3798-y

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