Abstract
Objectives & Aims: The evaluation and identify new prognostic markers suggested in recent studies for coronary heart disease ,raised platelets distribution width (PDW) has been found to be associated with poor prognosis after resent myocardial infarction. Evaluate the relationship between raised PDW and mortality morbidity after the initial attack of myocardial infarction (MI). Increased platelets distribution width (PDW) has been associated with adverse outcomes. We studied the association between raised PDW during hospital course with clinical outcomes survival index of patients with after acute myocardial infarction (AMI).
Material & Methods: Blood was collected in a sterile EDTA containing tube and processed following our established iso certified hospital based laboratory protocol. A complete blood counting including HB%, PCV, Red cell indices, platelet count, total white cell count and PDW was done by Automated blood cell counter. Level of Troponin I done by automated mini vidas bioanalyser.
Conclusion: we find significantly correlation in patients with post MI along with high PDW. PDW is an inexpensive cost effective and easily available laboratory test, high PDW with high troponin I for post MI have poor outcome of patients’ it could be used for mortality with morbidity risk assessment and follow up the patients after MI .we find that high PDW of raised troponin I pt. shows poor prognosis. confirmation of mi done by troponin I level of every patients.
Keyword: myocardial infarction, platelets distribution width.
References
- Kasper, Fauci, Hauser, Longo, Jameson and Loscalzo et al. Harrison’s Principles Of Internal Medicine 19th edition. United States Of America. (Mc Graw Hill); volume 2; 1442.
- Kumar et al. Robbins and Cotran Pathologic Basis Of Disease 7 th edition.( Pennsylvania. Elsevier); 571.
- Bonow, Mann, Zipes, Libby et al. Braunwald’s Heart Disease: A Text Book Of Cardiovascular Medicine 9 th edition. (Philadelphia. Elsevier); 55.
- Shuja-ur-Rehman, Sheikh S, Nazeer M. ST segment resolution post MI – a predictor of better outcomes. J Pak Med Assoc. 2008 May, 58(5) : 283-6.
- Salim R. Hamudi Al-Obeidi, Saad H. Ahmedm, Fatma A. Obeid. Evaluation of Platelet Indices in Patients with Acute Coronary Syndrome. Mustansiriya Medical Journal, June,12(1).2013.
- Lowe GD, Machado SG, Krol WF, Barton BA, Forbes CD. White blood cell count and haematocrit as predictors of coronary recurrence after myocardial infarction. Thromb Haemost. 1985 Oct, 30; 54 (3) : 700-3.
- Brauwald E. Evolution of the management of acute myocardial infarction: a 20th century saga. Lancet 1998; 352: 1771-4.
- Amsterdam E A et al. 2014 AHA/ACC Guidelines for the Management of Patients with Non-ST Elevation Acute Coronary Syndromes. Journal of the American College of Cardiology. Sep 2014.
- Y Birnbaum, B J Drew .The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis. Postgrad Med J 2003;79:490–504.
- Maroko P, Libby P, Ginks W, Bloor C, Shell W, Sobel B, Ross JJ. Early eff ects on local myocardial function and the extent of myocardial necrosis. J Clin Invest 1972; 51: 2710–6.
- Chazov EI, Matveeva LS, Mazaev AV, Sargin KE, Sadovskaia GV, Ruda MI. Intracoronary administration of fibrinolysin in acute myocardial infarct. Ter Arkh 1976; 48: 8–19.
- Nikhil Sikri, Amit Bardia. A History of Streptokinase use in Acute Myocardial Infarction. Text Heart Inst J 2007;34:318-27.
- Diwedi SK, Hiremath JS, Kerkar PG, Reddy KN, Manjunath CN, Ramesh SS, et al. Indigenous recombinant streptokinase vs natural streptokinase in acute myocardial infarction patients: Phase III multicentric randomized double blind trial. Indian J Med Sci 2005;59:200-7.
- Michels KB, Yusuf S. Does PTCA in acute myocardial infarction affect mortality and reinfarction rates? A quantitative overview (meta-analysis) of the randomized clinical trials. Circulation 1995; 91: 476-85.
- Andreotti F, Pasceri V, Hackett DR, Davies GJ, Haider AW, Maseri A. Preinfarction angina as a predictor of more rapid coronary thrombolysis in patients with acute myocardial infarction. N Engl J Med 1996; 334: 7-12.
- Grines CL, Topol EJ, O'Neill WW et al. Effect of cigarette smoking on outcome after thrombolytic therapy for myocardial infarction. Circulation 1995; 91: 298-303.
- Andreotti F, Patti G. Chronobiology of the haemostatic system. In: Redfern PH, Lemmer B, eds. Handbook of Experimental Pharmacology. Physiology and Pharmacology of Biological Rhythms.( Springer-Verlag, Heidelberg).
- Andreotti F. Procoagulant and fibrinolytic factors in blood: relation to the pathogenesis and treatment of acute coronary occlusion in man. PhD thesis, 1992. ISBN 90-5412-006-1. “Relationship Of Platelet Distribution Width And White Blood Cell Count On Admission .. DOI: 10.9790/0853-150802147172 www.iosrjournals.org 172 | Page
- Mauri F, Maggioni AP, Franzosi MG, et al. A simple electrocardiographic predictor of the outcome of patients with acute myocardial infarction treated with a thrombolytic agent. A GISSI-2 derived analysis. J Am Coil Cardiol 1994;24:600-7.
- Dissmann R, Schr6der R, Busse U, et al. Early assessment of outcome by ST-segment analysis after thrombolytic therapy in acute myocardial infarction. Am Heart J 1994;128:851-7.
- Neuhaus KL, von Essen R, Vogt A, et al. Dose finding with a novel recombinant plasminogen activator (BM 06.022) in patients with acute myocardial infarction: results of the German Recombinant Plasminogen Activator Study (GRECO). J Am Coil Cardiol 1994;24:55-60.
- Shah A, Wagner GS, Granger CB et al. Prognostic implications of TIMI flow grade in the infarct related artery compared with continuous 12-lead ST-segment resolution analysis. Reexamining the ‘gold standard’ for myocardial reperfusion assessment. J Am Coll Cardiol 2000; 35(3):666–72
- Ito H, Tomooka T, Sakai N et al. Lack of myocardial perfusion immediately after successful thrombolysis. A predictor of poor recovery of left ventricular function in anterior myocardial infarction. Circulation 1992;85(5):1699–705.
- van 't Hof AW, Liem A, de Boer MJ et al. Clinical value of 12-lead electrocard-iogram after successful reperfusion therapy for acute myocardial infarction. Zwolle Myocardial Infarction Study Group. Lancet 1997;350(9078):615–9.
- Buckley MF, James J W, Brown D E, Whyte G S, Dean MG, Chesterman CN, et al. A novel approach to the assessment of variations in the human platelet count. Throm Haemost 2000;83:480-84.
- Kaito K, Otsubo H, Usui N et al. Br J hematol 2005;128:698-702.
- Smith N, Panthansali R, Bath P. Platelets and stroke. Vascular medicine 1999;4:165-172.
- Bath PMW Butterworth R J. Platelet size : measurement, physiology and vascular disease. Blood 1996;7;157-161.
- O’Malley T, Langhorne P, Elton R, Stewart C. Platelet size in stroke patients. Stroke 1995;26:995-99.
- Varasteh-ravan H.R., Ali-Hassan-Sayegh S., Mohammad R. Mozayan, Ali Akbar, Karimi-bondarabadi. Relationship of admission mean platelet volume, platelet distribution width and white blood cells with ST resolution in paitents with acute ST segment elevation myocardial infarction treated with strepotokinase without history of previous cardiovascular surgery. Perspectives in Clinical Research. 2013;4:2.
- Park Y, Schoene N, Harris W, Mean platelet volume as an indicator of platelet activation : methodological issues. Platelets 2002; 13(5-6):301-306.
- Van der Loo B, Martin JF. A role for changes in platelet production in the cause of acute coronary. Arterioscler Thromb Vasc Biol 1999;19:672-9.
- Huczek Z, Kochman J Filipiak KJ, Horszczaruk GJ, Grabowski M, Piatkowski R, et al. Mean platelet volume on admission predicts impaired reperfusion and long-term mortality in acute myocardial infarction treated with primary percutaneous coronary interve-ntion. J Am Coll Cardiol 2005;46:284-90.
- Cetin M, Bakirci EM, Baysal E, Tasolar H, Balli M, Cakici M, Abus S, Akturk E, Ozgul S. Increased Platelet Distribution Width Is Associated With ST-segment Elevation Myocardial Infarction and Thrombolysis Failure. Angiology. 2014 Feb 12.
- Akashi K, et al: A clonogenic common myeloid progenitor that gives rise to all myeloid lineages. Nature 404:193, 2000.
- Kumar, et al. Robbins and Cotran Pathologic Basis of Diseases, 7th edition.( Pennysylvania. Elsevier); 663-664.
- Arnon Blum MD, Julia Sheiman MD, Yonathan Hasin MD. Leukocytes and Acute Myocardial infarction. IMAJ 2002;4: 1060- 1065.
- Zalokar JB, Richards JL, Blaude JR. Leukocyte count, smoking, and myocardial infarction. N Engl J Med 1981;394:465-8.
- Cole DR, Singian EB, Kate LN. The long term prognosis following myocardial infarction, and some factors which affect it. Circulation 1954;9:321-34.
- Maisel AS, Gilpin A, Lewinter M, et al. Initial leukocyte count during acute myocardial infarction independently predicts early ventricular fibrillation. Circulation 985;72(3) 414.
- Furman MI, Becker RC, Yarzebski J, Savegeau J, Gore JM. Goldberg RJ. Effect of elevated leukocyte count on in hospital mortality following acute myocardial infarction . Am J Cardiol 1996;78:945-8.
- Bagge U, Skalak R, Attefors R. Granulocyte rheology : experimental studies in an in vitro micro flow system. Adv Microcirc 1977;7:29-49.
- Dormandy J, Ernst E, Matrai A, eta al. Hemorrheological changes following acute myocardial infarction. Am Heart J 1982; 104:1364-7.
- Barron HV, Cannon CP, Murphy SA, Braunwald E, Gibson M. Association between white blood cell count, epicardial blood flow, myocardial perfusion, and clinical outcomes in the setting of acute myocardial infarction. Circulation 2000;102:2329-34.
- Diacovo TG, Roth SJ, Buccola JM, eta al. Neutrophil rolling, arrest, and transmigration across activate d, surface adherent platelets via sequential action of P selectin and the beta 2 integrin CD11b/CD18. Blood 1996;88:146-57.
- Yudkin JS, Kumari M, Humphries SE, Mohammed-Ali V ; Inflammation, obesity, stress and coronary heart disease: is interleukin-6 the link ? Atherosclerosis 2000, 148:209-214.
- Cannon CP, McCabe CH, Wilcox RG, Bentley HG, Braunwald E: Association of white blood cell count with increased mortality in acute myocardial infarction and unstable angina pectoris. OPUS-TIMI 16 Investigators. Am J Cardiol 2001, 87:636-9, A10.
- Barron HV, Cannon CP, Murphy SA, Braunwald E, Gibson CM; Association between white blood cell count, epicardial blood flow, myocardial perfusion, and clinical outcomes in the setting of acute myocardial infarction: a thrombolysis in myocardial infarction 10 substudy. Circulation 2000, 102:2329-2334.
Corresponding Author
Dr M.S.Koolwal
Email-This email address is being protected from spambots. You need JavaScript enabled to view it.