SA JOURNAL OF DIABETES & VASCULAR DISEASE
RESEARCH ARTICLE
VOLUME 13 NUMBER 2 • DECEMBER 2016
77
Mean platelet volume is associated with myocardial
perfusion defect in diabetic patients
Savas Sarikaya, Safak Sahin, Lutfi Akyol, Elif Borekci, Yunus Keser Yilmaz, Fatih
Altunkas, Kayihan Karaman, Seyhan Karacavus, Ali Riza Erbay
Correspondence to: Safak Sahin
Department of Internal Medicine, School of Medicine, Gaziosmanpa
ş
a
University, Tokat, Turkey
e-mail:
drsafaksahin@gmail.comSavas Sarikaya, Ali Riza Erbay
Department of Cardiology, School of Medicine, Bozok University, Yozgat,
Turkey
Lutfi Akyol, Elif Borekci
Department of Internal Medicine, School of Medicine, Bozok University,
Yozgat, Turkey
Yunus Keser Yilmaz
Department of Cardiovascular Surgery, School of Medicine, Bozok
University, Yozgat, Turkey
Fatih Altunkas, Kayihan Karaman
Department of Cardiology, School of Medicine, Gaziosmanpa
ş
a University,
Tokat, Turkey
Seyhan Karacavus
Department of Nuclear Medicine, School of Medicine, Bozok University,
Yozgat, Turkey
Previously published in
Cardiovasc J Afr
2014;
25
: 110–113
S Afr J Diabetes Vasc Dis
2016;
13
: 77–80
Abstract
Aim:
Our aimwas toevaluatewhether therewas a relationship
between mean platelet volume and myocardial perfusion
defect in diabetic patients using myocardial perfusion
imaging.
Method:
Forty-four diabetic patients with myocardial
perfusion defect (group 1) and 44 diabetic patients without
myocardial perfusion defect (group 2), matched for age
and gender, were retrospectively examined. Levels of mean
platelet volume (MPV) in the two groups were assessed.
Results:
MPVwas higher in group 1 than group 2 patients (8.76
± 0.76 and 8.25 ± 0.78 fl), respectively,
p
= 0.003). Levels of
glucose, triglycerides (TG), total cholesterol (TC), low-density
lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL)
cholesterol, haemoglobin (Hb) and glycosylated haemoglobin
(HbA
1c
), and body mass index (BMI) in the two groups were
not statistically significantly different. Multivariate logistic
regression analyses showed that MPV was the only variable
independently associated with myocardial perfusion defects
(OR: 2.401, 95% CI: 1.298–4.440,
p
= 0.013).
Conclusion:
This study showed that higherMPVwas associated
with myocardial perfusion defects. Higher MPV in diabetic
patients was independently related to myocardial perfusion
defects and may be an indicator of myocardial ischaemia.
Keywords:
myocardial perfusion defect, mean platelet volume,
diabetes mellitus
Diabetesmellitus (DM) is consideredacoronaryartery riskequivalent.
1
DM is associated with an increased risk of cardiovascular morbidity
and mortality.
2,3
DM may cause myocardial perfusion defects
involving the main coronary artery and myocardial microvascular
circulation. Myocardial perfusion imaging (MPI) is a useful non-
invasive tool to determine whether there is a myocardial perfusion
defect.
4
Platelet volume is a marker of platelet activation and function
and is measured as mean platelet volume (MPV).
5
MPV has become
a prognostic factor in coronary heart disease and may eventually
be accepted as a parameter of platelet activity.
6
MPV is emerging
as a new risk factor for vascular complications of DM of which
atherothrombosis plays a crucial role.
7
However, to the best of our knowledge, there have been no
reports in the literature to evaluate the relationship between
MPV and myocardial perfusion defect using MPI in patients with
diabetes. Our aim was to evaluate whether there was a relationship
between myocardial perfusion defect using myocardial perfusion
scintigraphy and MPV in selected diabetic patients.
Methods
Eighty-eight patients with type 2 diabetes who had MPI between
January and May 2013 in Bozok and Gaziosmanpa
ş
a universities
were retrospectively examined. Eighty-eight patients were enrolled
in the study and divided into two groups, matched for age and
gender: the myocardial perfusion defect group (group 1) and a
group with no myocardial perfusion defect (group 2). Group 1
consisted of 44 subjects (14 men and 30 women, mean age: 61.75
± 7.86 years). Group 2 consisted of 44 subjects (12 men and 32
women, mean age: 60.48 ± 9.28 years).
Patients with a history of myocardial infarction, unstable angina
pectoris, cardiac surgery, angiographically proven coronary artery
disease, endocrine disorder without diabetes, systemic inflammatory
disease, rhythm disorder, any medication that could affect the
MPV, suspicious scintigraphy results due to breast attenuation, and
aperture and fixed (scar) perfusion defects were excluded.
The blood samples were withdrawn following a 12-hour fast.
Glucose, creatinine and lipid profiles were determined using
standard methods. For both groups, we measured the MPV from
blood samples that were obtained following venipuncture. The
blood was collected in tripotassium EDTA tubes. We analysed the
blood samples using an automatic blood counter within one hour
of drawing the blood.
The patients underwent a two-day stress/rest single-photon-
emission tomography and gated GSPECT study using adenosine
with a standard weight-based infusion protocol (140 μg/kg/min).
The six-minute adenosine infusion was begun and 740 MBq
(20 mCi) of MIBI was injected after three minutes. After a 45-minute
delay, a stress set of images was acquired.
At rest, before receiving technetium-99m methoxy isobutyl