Prognostic Value of Platelet-to-Platelet Distribution Width Ratio in Postoperative Patients with Type A Acute Aortic Dissection
PPR is a Prognostic Factor in Type A AAD
DOI:
https://doi.org/10.1532/hsf.4605Keywords:
acute, platelet, platelet distribution width, type A aortic dissection, in-hospital mortalityAbstract
Objective: Acute type A aortic dissection (AAD) is a serious life-threatening cardiovascular emergency with high in-hospital mortality without aggressive clinical treatment. The study intended to identify the relationship between platelet (PLT) to platelet distribution width (PDW) ratio (PPR) and in-hospital mortality in postoperative patients with type A AAD.
Methods: A total of 171 type A AAD patients were recruited in this retrospective study from January 2017 to December 2019. Receiver operating characteristics (ROC) were exploited to determine the best cut-off value of PPR, and then patients were sub-grouped into the low-PPR group and high-PPR group, according to the optimal value of PPR. Finally, univariate, and multivariate analyses were carried out to examine the prognostic value of PPR.
Results: The value of PPR was 9.76, and the mortality was statistically higher in the low-PPR group than in the high-PPR group (29.1% vs. 6.0%, P < 0.01). The area under the ROC curve (AUC) of PPR was 0.724 (95% CI, 0.633-0.815; P < 0.001) with a 56.4% sensitivity and 80.6% specificity. Multivariate analysis showed that serum PPR was an independent factor associated with in-hospital mortality (hazard ratio (HR): 1.151; 95% confidence interval (CI): 1.035 -1.297; P = 0.010).
Conclusion: Serum PPR can be used as an independent predictor of in-hospital mortality in postoperative patients with type A AAD.
References
Akutsu K, Sato N, Yamamoto T, Morita N, Takagi H, Fujita N, et al. 2005. A rapid bedside D-dimer assay (cardiac D-dimer) for screening of clinically suspected acute aortic dissection. Circ J. 69(4), 397-403.
Carnevale D, Lembo G, Frati G. 2011. Chronic Type A aortic dissection: could surgical intervention be guided by molecular markers? J Cell Mol Med. 15(7), 1615-1619.
De Leon Ayala IA, Chen YF. 2012. Acute aortic dissection: an update. Kaohsiung J Med Sci. 28(6), 299-305.
Du R, Li D, Yu J, Ma Y, Zhang Q, Zeng Z, Zeng R. 2017. Association of platelet to lymphocyte ratio and risk of in-hospital mortality in patients with type B acute aortic dissection. Am J Emerg Med. 35(2), 368-370.
Gao Y, Li D, Cao Y, Zhu X, Zeng Z, Tang L. 2019. Prognostic value of serum albumin for patients with acute aortic dissection: A retrospective cohort study. Medicine (Baltimore). 98(6), e14486.
Gardiner EE, Andrews RK. 2014. Structure and function of platelet receptors initiating blood clotting. Adv Exp Med Biol. 844, 263-275.
Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. 2011. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 17(1), 47-58.
Golebiewska EM, Poole AW. 2015. Platelet secretion: From haemostasis to wound healing and beyond. Blood Rev. 29(3), 153-162.
Huang B, Tian L, Fan X, Zhu J, Liang Y, Yang Y. 2014. Low admission platelet counts predicts increased risk of in-hospital mortality in patients with type A acute aortic dissection. Int J Cardiol. 172(3), e484-486.
Kamisli O, Kamisli S, Kablan Y, Gonullu S, Ozcan C. 2013. The prognostic value of an increased mean platelet volume and platelet distribution width in the early phase of cerebral venous sinus thrombosis. Clin Appl Thromb Hemost. 19(1), 29-32.
Le VB, Schneider JG, Boergeling Y, Berri F, Ducatez M, Guerin JL, et al. 2015. Platelet activation and aggregation promote lung inflammation and influenza virus pathogenesis. Am J Respir Crit Care Med. 191(7), 804-819.
Li D, Ye L, Yu J, Deng L, Liang L, Ma Y, et al. 2017. Significance of the thrombo-inflammatory status-based novel prognostic score as a useful predictor for in-hospital mortality of patients with type B acute aortic dissection. Oncotarget. 8(45), 79315-79322.
Li DZ, Chen QJ, Sun HP, Zeng R, Zeng Z, Gao XM, et al. 2016. Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection. Blood Coagul Fibrinolysis. 27(6), 653-659.
Li DZ, Yu J, Du RS, Zeng R, Zeng Z. 2016. Thrombo-inflammatory status and prognosis of acute type A aortic dissection. Herz. 41(3), 250-251.
Liu JP, Wang YM, Zhou J. 2019. Platelet parameters aid identification of adult-onset Still's disease from sepsis. Neth J Med. 77(8), 274-279.
Luo F, Zhou XL, Li JJ, Hui RT. 2009. Inflammatory response is associated with aortic dissection. Ageing Res Rev. 8(1), 31-35.
Nienaber CA, Clough RE, Sakalihasan N, Suzuki T, Gibbs R, Mussa F, et al. 2016. Aortic dissection. Nat Rev Dis Primers. 2, 16071.
Semple JW, Italiano JE, Jr., Freedman J. 2011. Platelets and the immune continuum. Nat Rev Immunol. 11(4), 264-274.
Tsai TT, Trimarchi S, Nienaber CA. 2009. Acute aortic dissection: perspectives from the International Registry of Acute Aortic Dissection (IRAD). Eur J Vasc Endovasc Surg. 37(2), 149-159.
Zhang Z, Xu X, Ni H, Deng H. 2014. Platelet indices are novel predictors of hospital mortality in intensive care unit patients. J Crit Care. 29(5), 885 e881-886.
