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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.com

Savas 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