Is Mean Platelet Volume a Reliable Marker to Predict Ischemic Stroke in the Follow-Up of Patients with Carotid Stenosis?

BACKGROUND: The objective of the study is to evaluate the reliability of mean platelet volume (MPV) for predicting ischemic stroke (cerebrovascular event [CVE]) among patients with different degrees of carotid stenosis. METHODS: Fifty-two patients with CVEs, 136 patients with carotid artery disease (CAD), and 40 healthy volunteers were enrolled in this study. All participants were divided into the following groups according to CAD: absence of stenosis, less than 50% stenosis, 50%-69% stenosis, and 70% or more to total occlusion of the internal carotid artery. For each participant, the parameters of CAD were assessed using ultrasonography. To obtain the values of CRP and MPV and the leukocyte and platelet counts, all samples were processed within 30 minutes after blood collection. Univariate and multivariate analyses were used to evaluate the association between the values of serum C-reactive protein (CRP) and MPV and carotid stenosis. RESULTS: In terms of age and gender, there was no statistically significant difference between the groups (P = .094 and P = .428, respectively). However, CRP values in patients with CAD and CVEs were significantly higher than those in the controls (P < .001). There was no statistically significant difference between the CRP values in patients with CAD and CVEs (P = .249). Moreover, the MPV values did not show any significant difference between the groups (P = .053) and among the patients with CAD (P = .64). There was no positive correlation between serum CRP and MPV values in patients with CAD regarding the degree of carotid stenosis (r = .061, P = .477). CONCLUSION: The findings of this study claim that MPV has no predictive value during follow-up of the patients with CAD for CVEs.

Evaluation of right atrium-to-right ventricle diameter ratio on computed tomography pulmonary angiography: Prediction of adverse outcome and 30-day mortality.

OBJECTIVE: The aim of this study was to examine the association between right atrium (RA) and right ventricle (RV) diameters on computed tomography (CT) pulmonary angiography in response to acute pulmonary embolism (APE), in addition to 30-day mortality and adverse outcomes in patients with APE. METHODS: This retrospective study was accepted by the institutional ethics committee. From January 2013 to March 2014, 79 hospitalized adult patients with symptomatic APE were included. Inclusion criteria were a CT pulmonary angiography positive for pulmonary embolism, availability of patient records, and a follow-up of at least 30 days. A review of patient records and images was performed. The maximum diameters of the heart chambers were measured on a reconstructed four-chamber heart view, and the vascular obstruction index was calculated on CT pulmonary angiography. RESULTS: There were statistically significant relationships in both the RA/RV diameter ratio and the RV/left ventricle (LV) diameter ratio between patients with and without adverse outcomes (p<0.001 and 0.002, respectively). Furthermore, there was a statistically significant difference in the RA/RV diameter ratio, but not in the RV/LV diameter ratio, between those with and without 30-day mortality (p=0.002 and 0.148, respectively). CONCLUSIONS: Measurement of the RA/RV diameter ratio may be an alternative and useful method for predicting 30-day mortality and adverse outcome in patients with APE.

The increase in P-wave dispersion is associated with the duration of disease in patients with Behçet's disease.

AIM: P-wave dispersion (PD) has been reported to be associated with inhomogeneous and discontinuous propagation of sinus impulses. Behçet's disease (BD) is a chronic multi-system disease presenting with recurrent oral and genital ulceration, and relapsing uveitis. Left ventricular diastolic dysfunction, ventricular arrhythmia and sudden cardiac death have been documented in Behçet's disease. The aim of this study was to evaluate myocardial involvement noninvasively in patients with BD by measuring PD. METHODS: Study population included 29 patients with BD (group I), (16 males, mean age: 60.4+/-10.1 years), and 45 normal (group II), (23 males, mean age: 61.2+/-12.0 years). The maximum and minimum P-wave duration (Pmax and Pmin) and PD were measured from the 12-lead surface electrocardiogram. Echocardiographic examination was also performed. RESULTS: There was no statistically significant difference between two groups in respect to age, gender, hypertension, diabetes mellitus, hyperlipidemia and cigarette smoking (p>0.05). Pmax and PD of patients with BD were found to be significantly higher than those of control subjects (116.2+/-14.0 ms vs. 102.0+/-16.5 and 49.3+/-12.7 ms vs. 29.3+/-8.5 ms, respectively p<0.0001). Moreover, we found a significant positive correlation between PD with BD duration (r=0.78, p<0.0001). CONCLUSION: Pmax and PD are found to be greater in patients with BD than in controls and are related with the duration of the disease.