The effect of mean platelet volume at admission on the TIMI frame count after fibrinolytic theraphy in st segment elevated myocardial infarction patients

Aim and Purpose: Mean platelet volume (MPV) is a measure of platelet stimulation, activity and reproductivity. High MPV declared as a poor prognostic indicator in the patients of ST elevated Myocardial Infarction (STEMI). Our aim is to compare TIMI frame count and MPV in succesfully trombolytic treated patients whom routinely performed coronary angiography in the first 24 hours. Another aim is is if MPV is an indicator of thrombolytic treatment success or not in the group of STEMI patient whom admitted to hospital in the first 12 hours.Study plan: 145 patients who have taken thrombolytic theraphy in the first 12 hours of symptom onset was enrolled in study between the dates of 01 Jan 2010 and 01 Jul 2011. (113 man, 32 woman, mean age:59.6). Venous blood sample was taken from the patients in emergency department and trombolytic theraphy performed. Lowering of ST elevation % 50 or more was used as an indicator of recanalisation. Relationship between MPV and groups of successfully and failed trombolytic treated patients was evaluated. Coronary angiography was performed during first 24 hours to 123 successfully treated patients and TIMI frame count for infarct related artery was calculated. TIMI frame count over 40 determined as inadequate, under 40 determined as complete perfusion and the relationship between MPV was evaluated.Findings: MPV is 8.4 + 0.9 in successfully treated patients and 8.5 + 1.0 in the failed group of 22 patients and it is not statistically significant (p: 0.700). In the coronary angiography of 123 patients whose successfully treated by thrombolytic theraphy; full reperfusion was established in 57 patients and inadequate perfusion was established in 66 patients. Mean TIMI frame count was measured 54.2 + 12.6 in inadequate perfusion group and 31.5 + 5.5 in full reperfusion group (p< 0.01). MPV was measured 8.93 + 0.87 (fl) in inadequate reperfusion group and 7.92 + 0.80 in full reperfusion group and it is statistically significantly higher in inadequate reperfusion group (p< 0.001). Statistically significant positive corelation was determined between TIMI frame count and MPV. When MPV rise, TIMI frame count is also rising (p< 0.001-r:0.461)Result: Platelets play an important role in the course of acute myocardial infarction and effectiveness of treatment regime. Even higher MPV is not a prognostic indicator for the success of trombolytic treatment,it is related to ineffective antegrad flow and tissue perfusion in the patients whose artery was opened.