Association of mean platelet volume and red blood cell distribution width with coronary collateral development in stable coronary artery disease

Introduction
The prognostic value of hematological indices in cardiovascular diseases and the association between these parameters and cardiovascular conditions have been established in the literature.

Aim
In this study, we aimed to investigate the relation of mean platelet volume (MPV), MPV to platelet ratio (MPR) and red cell distribution width (RDW) with degree of coronary collateral development (CCD) in stable coronary artery disease (CAD) subjects with established critical coronary artery stenosis.

Material and methods
A total of 306 patients with stable angina pectoris undergoing coronary arteriography were enrolled and divided on the basis of the development of CCD into two groups: a group with adequate CCD (n = 214) and a group with impaired CCD (n = 92). Routine complete blood count and biochemical parameters were measured before coronary arteriography.

Results
The MPV and MPR levels were significantly higher in the inadequate CCD group (10.5 ±1.8 fl vs. 8.7 ±1.9 fl, p < 0.001 and 0.06 ±0.08 vs. 0.05 ±0.07, p = 0.036). Patients with inadequate CCD had significantly higher RDW levels compared to patients with adequate CCD (15.5 ±1.7% vs. 15.0 ±1.9%, p = 0.01). MPV and RDW were significantly associated with Rentrop collateral grading (r = –0.523, p < 0.001 and r = –0.239, p < 0.001, respectively), whereas the association with MPR was not significant. An MPV value greater than 9.95 fl, determined with ROC curve analysis, had 71% sensitivity and 70% specificity in predicting inadequate CCD. An RDW greater than 14.3% has 71% sensitivity and 53% specificity in selecting patients with adequate CCD.

Conclusions
The present study suggests that MPV and MPR may be associated with the degree of collateral development in chronic stable CAD. However, the negative association of RDW with inadequate CCD, in combination with previous contradictory reports, raises a doubt about the possible value of RDW in stable CAD. Although these parameters may be affected by various conditions, a high MPV may lead clinicians to suspect possible inadequate collateral development in stable CAD patients.