Mean Platelet Volume as a Predictor for Restenosis After Carotid Angioplasty and Stenting
Mean Platelet Volume as a Predictor for Restenosis After Carotid Angioplasty and Stenting
复制标题
平均血小板体积作为颈动脉血管成形术和支架置入术后再狭窄的预测因子。
DOI：
10.1161/strokeaha.117.019748
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发表时间：
2018-04-01
期刊：
影响因子：
8.3
通讯作者：
Xu, Gelin
中科院分区：
文献类型：
--
作者：
Dai, Zhengze;Gao, Jie;Xu, Gelin
背景和目的-血小板聚集在颈动脉血管成形术和支架植入术（CAS）后支架内再狭窄（ISR）的发展中起着至关重要的作用。平均血小板体积（MPV）已被建议作为血小板反应性的指标。本研究旨在探讨冠状动脉狭窄患者的冠状动脉狭窄与冠状动脉狭窄之间的关系。在CAS手术前测量MPV。在术后6个月和每年进行数字减影血管造影、计算机断层血管造影或多普勒超声检查。ISR定义为治疗病变狭窄≥ 50%。考克斯回归用于确定预测ISR后CAS.Results-of 261例CAS，46（17.6%）与ISR确定在平均随访12.1 +/- 16.1个月（范围，2.1-120.7）。在多变量分析中，基线MPV >10.1 fL（风险比，3.20; 95%置信区间，1.28-8.03），病变长度（风险比，1.05; 95%置信区间，1.02-1.08），残余狭窄（危险比，1.07; 95%可信区间，1.05-1.10）和基线血糖（危险比，1.01; 95%可信区间，1.00-1.02）与ISR相关。术前MPV高的患者可能受益于CAS后的强化抗血小板治疗。
Background and Purpose-Platelet aggregation plays a vital role in the development of in-stent restenosis (ISR) after carotid angioplasty and stenting (CAS). Mean platelet volume (MPV) has been suggested as an index of platelet reactivity. This study aimed to investigate the association between MPV and ISR in CAS patients.Methods-A total of 261 patients with CAS were enrolled. MPV was measured before CAS procedure. Digital subtraction angiography, computed tomographic angiography, or duplex ultrasonography was performed at 6 months and annually after the procedure. ISR was defined as >= 50% stenosis in the treated lesion. Cox regression was used to identify predictors of ISR after CAS.Results-Of the 261 patients with CAS, 46 (17.6%) were determined with ISR during a mean follow-up of 12.1 +/- 16.1 months (range, 2.1-120.7). On multivariate analysis, baseline MPV >10.1 fL (hazard ratio, 3.20; 95% confidence interval, 1.28-8.03), lesion length (hazard ratio, 1.05; 95% confidence interval, 1.02-1.08), residual stenosis (hazard ratio, 1.07; 95% confidence interval, 1.05-1.10), and baseline glucose (hazard ratio, 1.01; 95% confidence interval, 1.00-1.02) were associated with ISR.Conclusions-Elevated MPV may be associated with ISR after CAS. Patients with high preprocedural MPV may benefit from an intensified antiplatelet therapy after CAS.