Platelet distribution width and saphenous vein disease in patients after CABG
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. Ege1 · U. Guray2 · Y. Guray2 · S. Acıkgoz1 · B. Demirkan2 1 Clinic of Cardiology, Kavaklidere Umut Hospital, Ankara 2 Clinic of Cardiology, Ankara Yuksek Ihtisas Education and Research Hospital, Ankara
Platelet distribution width and saphenous vein disease in patients after CABG Association with graft occlusion
Introduction Coronary artery bypass grafting (CABG) is a highly effective method of relieving signs and symptoms of ischemic heart disease. The patency rates of saphenous vein grafts, which are the most common types of conduits used, predict the effectiveness of the surgery in both short and long term [1]. Beyond 1 year, newly developed atherosclerosis becomes the major reason for sapheneous graft stenosis and occlusion [2, 3]. Inflammation plays an important role during all stages of atherosclerosis, from its initiation to progression. Red blood cell distribution width (RDW), which is a measure of the variability in size of circulating erythrocytes, is associated with adverse outcomes in patients with various types of cardiovascular diseases including acute coronary syndromes and heart failure [4, 5, 6, 7, 8]. Moreover, platelets have been implicated in the pathogenesis of cardiovascular disorders including atherosclerosis and its complications [9]. Platelets participate in atherosclerosis, not only as mediators of thrombus formation but also as inducers of inflammation. During the first stage of atherosclerosis, blood inflammatory leukocytes interact with the damaged endothelium that is rich in platelets and in the last stage of disease platelets secrete several inflammatory molecules which increase the instability of the atherosclerotic plaque causing rupture and thrombosis [10]. In a recent study by Ozkan et
al. [11], increased mean platelet volume, which is an indicator of platelet function, was found to be an independent predictor of acute myocardial infarction in young patients. It was also demonstrated that increased mean platelet volume levels were associated with the severity of coronary artery disease and were the independent predictors of multivessel coronary artery disease [12]. Larger platelets are also metabolically and enzymatically more active than small platelets. Platelet distribution width (PDW) directly measures the variability in platelet size and has been shown to reflect platelet activity. On the other hand, in the recent study of De Luga et al. [13], no relation was found between the extent of coronary artery disease and PDW. In our opinion, inflammatory process in atherosclerosis may cause an increase in RDW and PDW values. Therefore, in this study we aimed to investigate whether there was a relationship between saphenous vein graft disease and both RDW and PDW values in patients with CABG surgery examined >1 year after the index operation.
Methods The study included 109 consecutive patients (86 men, 23 women, mean age 64±9.6 years) who underwent coronary angiography at two different institutions between April 2011 and July 2011. All patients had stable anginal symptoms and/
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