Metabolic syndrome and mean platelet volume variation in patients with chest pain and negative cardiac enzymes.

INTRODUCTION: The mean platelet volume (MPV) is an easily measurable parameter directly correlated with platelet aggregation function, proven to be increased in acute coronary syndromes, but also in the presence of cardiovascular risk factors such as the metabolic syndrome, dyslipidemia, diabetes mellitus, arterial hypertension. OBJECTIVE: This study intended to assess the role of the metabolic syndrome in MPV variation in patients presenting with chest pain. MATERIALS AND METHODS: We retrospectively analyzed data from 122 patients with chest pain and negative cardiac enzymes admitted consecutively to our clinic from September 1st 2011 to January 30th 2012. Our group included 27 (22.13%) patients with stable angina (SA), 74 (60.65%) patients with unstable angina (UA) and 21 (17.22%) patients with non-coronary chest pain. RESULTS: Patients with UA had a higher mean value of the MPV 9.31 ± 1.19 fL compared to patients with SA 8.72 ± 1.14 fL (p=0.0279) and patients with non-coronary chest pain 8.85 ± 0.90 L (p=0.0908). All the patients with metabolic syndrome had increased MPVs, regardless of the etiology of chest pain. Patients with non-coronary chest pain presented significantly higher MPVs if associated with metabolic syndrome or arterial hypertension. CONCLUSIONS: Patients with cardiovascular risk factors, especially complex ones like the metabolic syndrome had an increased MPV, as did the patients with UA whether or not associated with the risk factors. In patients without such comorbidities, the MPV could be useful in distinguishing unstable angina from non-coronary chest pain.

Clinical, biological, echocardiographic and therapeutic determinants of the length of hospital stay of patients with acute heart failure.

HYPOTHESIS: The length of hospital stay (LOS) is a unanimously accepted measure of risk and treatment efficacy for in-patients. PURPOSE: Our aim was to identify the parameters with predictive value for the LOS of patients with acute heart failure (AHF). METHODS: We analyzed 125 patients consecutively admitted to our clinic with a slight male predominance (54.4%) and a mean age of 71.54 years. Patients were divided into groups according to the clinical form at presentation and left ventricular function. Mean LOS was of 8.74 days. RESULTS: Patients with LVEF<30% had a significantly higher LOS compared to those with LVEF>30% (F(2)=6.54, p<0.05). The same difference was discovered for those who received inotropic support (p<0.001), i.v. loop diuretic>140mg (p<0.001) as well as for those with QRS>160ms (p<0.05) or LBBB. The linear regression equation exposed a single significant statistical model indicating that the need for vasopressor amines, mean diuretic dose and PAAT<90msec explain 56% of the variance of LOS F(3.46)=20.55, p<0.001. The highest contribution to the model was achieved by the need for vasopressor amines (ß=0.66), with a unique contribution of 42% to the variance of the number of days of stay. The mean dose of diuretic had ß=0.27 and a unique contribution to the model of 7.2%, followed by PAAT<90 msec with ß=0.26 and a unique contribution to the model of 7%. CONCLUSIONS: LOS is influenced by numerous parameters, some specific to certain clinical forms of AHF while others are independent, which is why evaluations on larger groups of patients are further needed.