Prognostic Value of Admission Mean Corpuscular Volume for Major Adverse Cardiovascular Events following Stent Implantation in Nondiabetic and Diabetic Patients with Acute Coronary Syndrome
Lele ChengLisha ZhangJunhui LiuWenyuan LiXiaofang BaiRuifeng LiBolin LiLijun WangJuan ZhouYue WuZuyi Yuan
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One of the key concerns of the clinician is to identify and manage risk factors for major adverse cardiovascular events (MACEs) in nondiabetic and diabetic patients with acute coronary syndrome (ACS) undergoing stent implantation. Mean corpuscular volume (MCV) is a marker of erythrocyte size and activity and is associated with prognosis of cardiovascular disease. However, the role of admission MCV in predicting MACEs following stent implantation in diabetes mellitus (DM), non-DM, or whole patients with ACS remains largely unknown.A total of 437 ACS patients undergoing stent implantation, including 294 non-DM (59.08 ± 10.24 years) and 143 DM (63.02 ± 9.92 years), were analyzed. Admission MCV was higher in non-DM than DM patients. During a median of 31.93 months follow-up, Kaplan-Meier curve demonstrated that higher admission MCV level was significantly associated with increased MACEs in whole and non-DM, but not in DM patients. In Cox regression analysis, the highest MCV tertile was associated with higher MACEs in whole ([HR] 1.870, 95% CI 1.113-3.144, P = 0.018), especially those non-DM ([HR] 2.089, 95% CI 1.077-4.501, P = 0.029) patients after adjustment of several cardiovascular risk factors. MCV did not predict MACEs in DM patients. During landmark analysis, admission MCV showed better predictive value for MACEs in the first 32 months of follow-up than in the subsequent period. Finally, the receiver operating characteristic (ROC) curve was conducted to confirmed the value of admission MCV within 32 months.In patients with ACS, elevated admission MCV is an important and independent predictor for MACEs following stent implantation, especially amongst those without DM even after adjusting for lifestyle and clinical risk factors. However, as the follow-up period increased, the admission MCV lost its ability to predict MACEs.Erythrocyte mean corpuscular volume and mean corpuscular hemoglobin levels were higher in children with Down syndrome than in normal control subjects. Reference values for mean corpuscular volume and mean corpuscular hemoglobin level derived from normal populations may be inappropriate for children with Down syndrome. These findings may have important implications for the diagnosis of iron deficiency in these children. Erythrocyte mean corpuscular volume and mean corpuscular hemoglobin levels were higher in children with Down syndrome than in normal control subjects. Reference values for mean corpuscular volume and mean corpuscular hemoglobin level derived from normal populations may be inappropriate for children with Down syndrome. These findings may have important implications for the diagnosis of iron deficiency in these children.
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Mean corpuscular volume may correlate with erythrocyte 6-thioguanine nucleotide concentrations in patients treated with azathioprine and 6-mercaptourine. We conducted a study of 166 patients with inflammatory bowel disease treated with azathioprine or 6-mercaptopurine to determine the relationship between mean corpuscular volume and erythrocyte 6-thioguanine nucleotide concentrations, disease activity as measured by the Inflammatory Bowel Disease Questionnaire (active disease <170, remission >170), and leukopenia. Blood was submitted for mean corpuscular volume, whole blood 6-thioguanine nucleotide concentration, and leukocyte count. The mean ± SD mean corpuscular volume during treatment was 94.7 ± 6.6 fL and the mean ± SD change in mean corpuscular volume was 7.5 ± 6.3 fL. There were significant correlations between mean corpuscular volume and erythrocyte 6-thioguanine nucleotide concentration (rs = 0.33, p < 0.001) and between change from baseline in mean corpuscular volume and erythrocyte 6-thioguanine nucleotide concentration (rs = 0.26, p = 0.001). There was no correlation between Inflammatory Bowel Disease Questionnaire scores and mean corpuscular volume values (rs = 0.01, p = 0.94). The mean corpuscular volume values in 55 patients with active disease and 111 patients in remission were similar (95.1 vs. 94.5 fL, p = 0.57). There was a weak negative correlation between the mean corpuscular volume and the leukocyte count, (rs = −0.18, p = 0.022). In patients with inflammatory bowel disease treated with azathioprine or 6-mercaptopurine, mean corpuscular volume and change from baseline in mean corpuscular volume correlated with erythrocyte 6-thioguanine nucleotide concentrations and negatively with leukocyte counts, but did not correlate with disease activity as measured by the Inflammatory Bowel Disease Questionnaire. Measurement of mean corpuscular volume is a simple and inexpensive alternative to measurement of 6-thioguanine nucleotide concentrations in patients treated with azathioprine or 6-mercaptopurine.
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Negative correlation was observed between erythrocyte count (RBC) and mean corpuscular volume (MCV) or mean corpuscular haemoglobin (MCH) in both sexes of diabetic and non-diabetic Libyans. The slopes of regression lines for MCV-RBC and MCH-RBC of diabetic patients were significantly lower (P less than 0.001) than those of their non-diabetic counterparts. Positive correlation was found between MCH and MCV. The slope of the regression line for MCH-MCV of diabetic patients was not significantly different from that of non-diabetic subjects.
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Background and objectives Mean corpuscular volume is the measure of the average size of the circulatory erythrocyte, and it is principally used as an index for the differential diagnosis of anemia. Recently, mean corpuscular volume has been associated with mortality in many clinical settings. However, the association of mean corpuscular volume with mortality in patients with CKD has not been fully addressed. Design, setting, participants, & measurements We conducted a retrospective observational cohort study of 1439 patients with stages 3–5 CKD and baseline mean corpuscular volume values from 2004 to 2012 in a medical center. The study cohort was divided into the high–mean corpuscular volume group and the low–mean corpuscular volume group by the median value (90.8 fl) of mean corpuscular volume. The baseline patient information included demographic data, laboratory parameters, medications, and comorbid conditions. The independent association of mean corpuscular volume with mortality was examined using multivariate Cox regression analysis. Results Of the 1439 participants, 234 patients (16.2%) died during a median follow-up of 1.9 years (interquartile range, 1.1–3.8 years). The crude overall mortality rate was significantly higher in the high–mean corpuscular volume group (high–mean corpuscular volume group, 22.7%; low–mean corpuscular volume group, 9.7%; P <0.001). In the fully adjusted models, the high–mean corpuscular volume group was associated with higher risks of all-cause mortality (hazard ratio, 2.19; 95% confidence interval, 1.62 to 2.96; P <0.001), cardiovascular mortality (hazard ratio, 3.57; 95% confidence interval, 1.80 to 7.06; P <0.001), and infection-related mortality (hazard ratio, 2.22; 95% confidence interval, 1.41 to 3.49; P =0.001) compared with the low–mean corpuscular volume group. Conclusions In patients with stages 3–5 CKD, mean corpuscular volume was associated with all-cause mortality, cardiovascular disease mortality, and infection-associated mortality, independent of other factors. The underlying pathophysiologic mechanisms warrant additional investigation.
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In this study, children with sickle cell anemia were evaluated for iron deficiency. Serum ferritin and free erythrocyte protoporphyrin free erythrocyte protoporphyrin (FEP) levels, mean corpuscular volume mean corpuscular volume (MCV) and mean corpuscular hemoglobin mean corpuscular hemoglobin (MCH) were used in determining their iron status. The study was done at Pediatric Hematology Outpatient Clinic of the Obafemi Awolowo University Teaching Hospitals' Complex, Ile-Ife. Forty-eight HbSS subjects in steady state and 48 apparently well age and sex matched HbAA controls were evaluated. Serum ferritin less than 25ng/dL FEP greater than cut off for age, mean corpuscular volume MCV and mean corpuscular hemoglobin MCH less than cut off for age were regarded as indicating iron deficiency. Serum ferritin values ranged from 34.2 to 3282.9μg/L, with a mean of 381.2 (1.0), median 180μg/L; which was significantly higher than the controls (p=0.000). FEP was lower in the subjects but none was iron deficient compared with the controls. The mean corpuscular hemoglobin MCH of subjects was significantly lower than the controls. Subjects had lower mean corpuscular volume MCV compared with controls. Iron deficiency was not detected in any of the subjects with sickle cell anemia in comparison to a prevalence of 43.75% in the controls. Iron deficiency anemia (IDA) was found in 16.7% of the controls, using the WHO cut off for anemia which is hemoglobin concentration of <11g/dl. While a high prevalence of iron deficiency was noted in the control group, patients with sickle cell anemia were largely iron sufficient, despite their anemia. Iron supplementation remains unnecessary as part of routine management of children with sickle cell anemia in our practice.
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ENWEndNote BIBJabRef, Mendeley RISPapers, Reference Manager, RefWorks, Zotero AMA Okruhlica L, Kamendy Z. Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients. Alcoholism and Drug Addiction/Alkoholizm i Narkomania. 2018;31(4):265-272. doi:10.5114/ain.2018.83750. APA Okruhlica, L., & Kamendy, Z. (2018). Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients. Alcoholism and Drug Addiction/Alkoholizm i Narkomania, 31(4), 265-272. https://doi.org/10.5114/ain.2018.83750 Chicago Okruhlica, Lubomir, and Zuzana Kamendy. 2018. "Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients". Alcoholism and Drug Addiction/Alkoholizm i Narkomania 31 (4): 265-272. doi:10.5114/ain.2018.83750. Harvard Okruhlica, L., and Kamendy, Z. (2018). Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients. Alcoholism and Drug Addiction/Alkoholizm i Narkomania, 31(4), pp.265-272. https://doi.org/10.5114/ain.2018.83750 MLA Okruhlica, Lubomir et al. "Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients." Alcoholism and Drug Addiction/Alkoholizm i Narkomania, vol. 31, no. 4, 2018, pp. 265-272. doi:10.5114/ain.2018.83750. Vancouver Okruhlica L, Kamendy Z. Prevalence of gamma-glutamyltransferase and mean corpuscular volume laboratory markers in alcohol dependent patients. Alcoholism and Drug Addiction/Alkoholizm i Narkomania. 2018;31(4):265-272. doi:10.5114/ain.2018.83750.
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The Digital Holographic Microscopy was applied to obtain hematological parameters in healthy and unhealthy individuals. The parameters analyzed were: mean corpuscular volume, mean corpuscular hemoglobin and the concentration of the mean corpuscular hemoglobin.
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Vitamin D has a steroid- and an anabolic-resembling chemical structure. Vitamin D is essential for many processes in the human body after hydroxylation.To investigate the impact of 25-hydroxy-vitamin D plasma concentrations on the blood parameters number of erythrocytes, hematocrit, mean corpuscular hemoglobin and mean corpuscular volume.Serial assessments were done in 290 patients with multiple sclerosis and repeated after a mean interval of 245 days. A recommendation for vitamin D supplementation was given in case of a concentration lower than 20 ng/mL combined with a prescription of a formulation containing vitamin D but not vitamin K.There was a fall of vitamin D in 119 subjects and a rise in 164, while no change appeared in 7 participants. When vitamin D values went down between both assessments moments, the computed increase of mean corpuscular haemoglobin was significantly lower compared with the rise of mean corpuscular haemoglobin associated with a vitamin D elevation. When vitamin D declined, the computed fall of mean corpuscular volume fall was significantly lower compared with the decrease of mean corpuscular volume, when vitamin D rose. Positive correlations were found between differences of vitamin D and mean corpuscular haemoglobin, respectively mean corpuscular volume. Inverse relations appeared between disparities of vitamin D and erythrocytes, respectively haematocrit.The elevation of vitamin D plasma levels provides enhanced preconditions for a better tissue oxygenation on a cellular level.
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