The Relationship Between Mean Platelet Volume and In-Hospital Mortality in Geriatric Patients with ST Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Objective:We planned to investigate the effect of mean platelet volume(MPV)on in-hospital mortality and coronary risk factors in geriatric patients with ST segment elevation myocardial infarction(STEMI)who underwent primary percutaneous coronary intervention(PCI).Methods:We enrolled 194 consecutive STEMI patients.The study population was divided into two groups on the basis of admission MPVs.The high-MPV group(n=49)included patients in the highest tertile(>8.9 fL),and the low-MPV group(n=145)included patients with a value in the lower two tertiles(≤8.9 fL).Clinical characteristics,in-hospital mortality,cardiovascular risk factors,and outcomes of primary PCI were analyzed.Results:The patients in the high-MPV group were older,more of them had three-vessel disease,and they had higher in-hospital mortality.Patients with in-hospital death were older,had higher Gensini score,creatinine concentration,and MPV,and had lower HDL cholesterol concentration.MPV,age,HDL cholesterol concentration,creatinine concentration,and Gensini score were found to be independent predictors of in-hospital death.Conclusion:These results suggest that high admission MPV levels are associated with increased in-hospital mortality in geriatric patients with STEMI undergoing primary PCI.

Impact of Postdilation on Intervention Success and Long-Term Major Adverse Cardiovascular Events(MACE)among Patients with Acute Coronary Syndromes

Postdilation is frequently used during coronary interventions to prevent stent malapposition.Currently there are contradictory fi ndings regarding the benefi ts of postdilation for both intraprocedural and long-term outcomes.We evaluated the impact of postdilation among patients who presented with acute coronary syndromes(ACS)and underwent percutaneous coronary interventions(PCI).A total of 258 consecutive patients who presented with ACS and underwent PCI were included in the study.The patients were followed up for 25±1.7 months for the occurrence of major adverse cardiovascular events(MACE).During follow-up,65 patients(25.2%)had MACE.Among patients without MACE,intracoronary nitrate infusion was less frequently used(P=0.005),myocardial blush grade was higher(P<0.001),and a drug-eluting stent was more frequently used(P=0.005).No signifi cant differences were noted between groups regarding the predilation,recurrent dilation,postdilation,and other angiographic characteristics.In multivariate analysis,female sex(P=0.047),myocardial blush grade(P=0.038),previous coronary artery disease(P=0.030),and peak troponin level(P=0.002)were found to be predictors of MACE.In patients who were treated with PCI for ACS,performing postdilation did not predict fi nal Thrombolysis in Myocardial Infarction(TIMI)fl ow grade,corrected TIMI frame count,myocardial blush grade,or MACE.

Coincidence of three solid tumors in a patient with multiple myeloma

Multiple primary cancers （MPC） are specific .malignant tumors type, manifesting as more than one primary tumor diagnosed in the same patient, either simultaneously or sequentially. The diagnostic criteria include： the cancer must be clearly malignant as determined by histological evaluation; each cancer must be geographically separate and distinct;