Joint effect of platelet distribution width and stent surface area on major adverse cardiovascular events after percutaneous coronary intervention

Background: This study was conducted to analyze the influences of stent surface area (SSA), platelet distribution width (PDW), and the joint effect of these 2 risk factors on major adverse cardiovascular events (MACEs) in patients treated with percutaneous coronary intervention (PCI) together with drug-eluting stent (DES) implantation. Methods: Based on a cross-sectional survey conducted between 2011 and 2012, a prospective cohort study was enrolled consiting of 442 patients who had undergone PCI with DES implantation. We categorized the participants into 4 subgroups according to PDW and SSA. Cox proportional hazards models were applied to explore the correlation of PDW and SSA with MACE incidence. Results: During the 12 months of follow-up time, 87 patients experienced MACEs, which included 4 deaths (4.6%), 5 nonfatal myocardial infarctions (MIs) (5.75%), 9 ischemic strokes (10.34%), and 73 clinically relevant bleeding episodes (83.91%). The risks of MACEs were decreased by SSA and increased by PDW. However, the association of PDW or SSA with MACE was not statistically significant. Compared with the patients with PDW >= 13.5% and SSA <358.14 mm(2), the multivariable adjusted hazard ratios [HRs; 95% confience interval (CI)] of the total MACEs for the patients with PDW <13.5% and SSA >= 358.14 mm(2), and with PDW >= 13.5% and SSA >= 358.14 mm(2) were 0.94 (95% CI: 0.55-1.64) and 0.37 (95% CI: 0.18-0.76), respectively. Additionally, the patients in the group of PDW <13.5% and SSA <358.14 mm(2), and PDW >= 13.5% and SSA >= 358.14 mm(2) had respective HRs of 0.47 (95% CI: 0.24-0.91) and 0.28 (95% CI: 0.13-0.63) for 12-month bleeding events when PDW >= 13.5% and SSA <358.14 mm(2)was used as a group reference. Conclusions: Our present results suggest that the joint effect of PDW and SSA was significantly correlated to MACE development in the patients treated with PCI (with DES implantation).