Background: The mean platelet volume to platelet count ratio (MPV/PC) has been investigated in the diagnosis, prognosis and risk stratification in several diseases. However, the predictive role of MPV/PC in left atrial stasis (LAS) of non-valvular atrial fibrillation (NVAF) patients remains unknown.
Methods: A total of 217 consecutive NVAF patients undergoing transesophageal echocardiogram (TEE) evaluation were retrospectively enrolled. The demographic, clinical, admission laboratory and TEE data were extracted and analyzed. Patients were categorized into those with or without LAS. The associations between the MPV/PC ratio and LAS were assessed by multivariate logistic regression analysis.
Results: There were 24.9% (n = 54) patients with LAS according to TEE. Compared with patients without LAS, the MPV/PC ratio was significantly higher in those with LAS (5.6± 1.6 vs 4.8± 1.0, P < 0.001). After multivariable adjustment, higher MPV/PC ratio levels (OR 1.747, 95% CI 1.193– 2.559, P = 0.004) were positively associated with LAS, with the optimal cut-point for LAS prediction of 5.36 (area under the curve, AUC = 0.683, sensitivity 48%, specificity 73%, 95% CI 0.589– 0.777, P < 0.001). The stratification analysis showed that a significant positive correlation between MPV/PC ratio ≥ 5.36 and LAS in patients of male, younger (< 65 years), paroxysmal AF, without history of stroke/TIA, CHA₂DS₂-VASc score ≥ 2, left atrial diameter (LAD) ≥ 40mm and left atrial volume index (LAVI) > 34mL/m² (all P < 0.05).
Conclusion: Increasing MPV/PC ratio was associated with an increased risk of LAS, which was mainly reflected in the subgroups of male, younger (< 65 years), paroxysmal AF, without history of stroke/TIA, CHA₂DS₂-VASc score ≥ 2, LAD ≥ 40mm and LAVI > 34mL/m² patients.
Keywords: non-valvular atrial fibrillation, mean platelet volume to platelet count ratio, left atrial appendage thrombus, spontaneous echo contrast