Association between PDW and Long Term Major Adverse Cardiac Events in Patients with Acute Coronary Syndrome Şeref Ulucan Ahmet Keser Zeynettin Kaya Mustafa Bilgi İsmail Ateş Mehmet Sıddık Ülgen
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Platelet Distribution Width (PDW) and Cardiovascular Outcomes in ACS Patients
This study provides a preliminary evaluation of the potential association between platelet distribution width (PDW) and the frequency of major adverse cardiovascular events (MACEs). The research focuses specifically on patients diagnosed with acute coronary syndrome (ACS), aiming to determine if PDW levels can serve as a reliable prognostic indicator for clinical outcomes.
Study Methodology and Patient Population
The retrospective study analyzed a total of 679 consecutive patients with ACS who underwent primary percutaneous coronary intervention via the transradial approach (TRA). The study population was characterized by the following parameters:
- Demographics: 498 males (73.3%) with a mean age of 63.31 ± 11.2 years.
- Clinical Diagnosis: 320 patients with acute myocardial infarction and 359 patients with unstable angina pectoris.
- Categorization: Patients were divided into tertiles based on their baseline PDW levels to analyze the associations between these levels and both in-hospital and long-term MACEs.
Key Findings and Statistical Results
The research revealed significant correlations between high PDW values and adverse clinical events. Patients in the highest PDW tertiles demonstrated increased frequencies of several complications:
| Clinical Event | Significance (P-value) |
|---|---|
| In-hospital instent thrombosis | P = 0.05 |
| Long-term instent restenosis | P = 0.005 |
| Long-term total MACEs | P = 0.008 |
According to multivariate analyses, PDW was identified as an independent predictor of both in-hospital and long-term MACEs (odds ratio 1.081, 95% confidence interval 1.003-1.165; p=0.042). Furthermore, the Kaplan-Meier incidence of MACEs across the PDW tertiles at 40 months was recorded as 12.8%, 12.1%, and 21.6% respectively (p=0.003), highlighting a significantly higher risk in the top tertile.
Conclusion: Clinical Implications of PDW
The results of this study conclude that pre-procedural PDW levels are a significant clinical marker. It may serve as an independent predictor for both short-term (in-hospital) and long-term adverse outcomes in patients suffering from acute coronary syndrome. Monitoring PDW levels could therefore be vital in assessing the risk profile of ACS patients undergoing coronary interventions.
