Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction
Acta Diabetologica
Association between multimorbidity and mean platelet volume in diabetic patients with acute myocardial infarction
Bartosz Hudzik 0
Ilona Korzonek‑Szlacheta 0
Janusz Szkodziński 0
Radosław Liszka 0
Andrzej Lekston 0
Barbara Zubelewicz‑Szkodzińska 0
Mariusz Gąsior 0
Managed By Antonio Secchi. 0
0 Department of Nutrition-Related Disease Prevention, School of Public Health in Bytom, Medical University of Silesia , Katowice , Poland
1 Bartosz Hudzik
Aims Diabetes mellitus (DM) is one of the most frequently detected conditions in multimorbid disease clusters. Platelet activation is one of the key mechanisms underlying atherothrombosis in acute myocardial infarction. Available data link mean platelet volume (MPV) to poor prognosis not only in cardiovascular and non-cardiovascular disease. Given the lack of research data on the association between disease clusters and MPV, we have set out to investigate the link between multimorbidity and MPV in diabetic patients with acute myocardial infarction. Methods A total of 277 patients with DM and STEMI undergoing primary percutaneous coronary intervention were enrolled. Based on the number of comorbidities the study population was divided into two groups: group 1 (N = 58) with ≤ 1 comorbidity and group 2 (N = 219) with ≥ 2 comorbidities. A subanalysis was performed within the multimorbidity group: group 2A with two or three comorbidities (N = 156) and group 2B with at least four comorbidities (N = 63). Results In the study population, 15.9% of patients had one comorbidity, and 22.0, 34.3, and 22.7% of patients had two, three, or at least four comorbid conditions, respectively. Both MPV and PDW were elevated in multimorbid patients (9.3 vs 10.8 fl and 9.5 vs 10.3 fl, respectively). The highest platelet volume indices were observed in patients with at least four comorbid conditions. There was a moderate positive correlation between MPV and the total number of comorbidities, the number of CVD comorbidities, and the number of non-CVD comorbidities. Conclusions These findings indicate that multimorbidity is associated with an increase in platelet volume indices. MPV values increased with the increasing number of comorbid conditions. Importantly, MPV values were elevated in some, but not all CVD and non-CVD conditions.
Multimorbidity; Diabetes mellitus; Myocardial infarction; Mean platelet volume
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Bartosz Hudzik and Ilona Korzonek-Szlacheta have contributed
equally to this work.
Third Department of Cardiology, Silesian Center for Heart
Disease, School of Medicine with the Division of Dentistry
in Zabrze, Medical University of Silesia, Katowice, Poland
Introduction
Type 2 diabetes mellitus (DM) has become one of the more
prevalent conditions worldwide in the past few decades [
1
].
DM is a chronic condition that is associated with a plethora
of complications. This, in turn, results in high morbidity
and mortality. Diabetic patients have at least one
coexisting chronic disease and approximately 40% have at least
three [
2, 3
]. DM is one of the most commonly measured
diseases in studies of multimorbidity, and more importantly
it is one of the most frequently detected conditions in
multimorbid disease clusters [
4, 5
]. Patients with diabetes
mellitus who are hospitalized for other health problems may
have increased risk of in-hospital death and longer hospital
stay. For this reason, diabetes should be promptly
recognized upon admission and properly managed [
6
]. That said,
the risk of cardiovascular and other macrovascular
complications varies substantially among diabetic patients [
7,
8
]. Diabetes is a major contributor to the development of
cardiovascular disease (CVD), stroke, chronic kidney
disease, non-traumatic lower limb amputations, and blindness.
Growing number of chronic diabetes-related complications
and comorbid conditions have been associated with poor
metabolic control, less optimal disease management, higher
health service utilization, impaired physical functioning, and
worse outcomes [
5, 9–11
].
Platelet activation is one of the key mechanisms
underlying atherothrombosis in acute myocardial infarction [
12
].
Platelets of diabetic patients are characterized by
dysregulation of several signaling pathways, which leads to increased
platelet reactivity. This may play a role not only in the higher
risk of developing acute myocardial infarction and the worse
outcomes observed in DM, but also in the larger
proportion of DM patients with inadequate response to antiplatelet
agents compared with non-DM patients [
13
]. The methods
of testing platelet activity may be very time consuming,
expensive, and technically difficult [
14
]. The mean platelet
volume (MPV) is a readily available parameter with routine
blood counts by automated hemograms and, therefore, is an
attractive index to study in clinical scenarios [
15
]. Available
data show that increased MPV is linked to the presence of
risk factors for cardiovascular diseas (...truncated)