8%) in the resolution group higher than 70% versus 71 patients (54.2%) lower than 70%). Of all the patients, 162 (57.8%) patients were suffering from STEMI at the anterior part of the heart (29% with greater resolution versus 71% with resolution <70%) and 118 patients (42.1%) at the inferior part of the heart (55.4% resolution higher than 70% scientific research versus 46.6% resolution lower than 70%). Therefore the patients with MI at the anterior part of the heart had a higher disorder in ST segment resolution which was also statistically significant (P = 0.0001). ROC curve was utilized to determine various cut-off points of WBC, MPV and PDW to predict non-resolution of ST segment and appropriate cut-off point was determined where the sum of sensitivity and characteristics lied at highest level.
To predict impaired reperfusion, ROC analysis was performed at the cut off points of 12.65 ?? 103??l, 10.05 FL, 12.58 FL so we could find the highest sensitivity and specificity for WBC, MPV and PDW respectively with the following values: 0.65, 0.80 and 0.81. As it is shown compared with MPV and WBC, PDW values of 0.81 is the best discriminating value in predicting non-resolution of ST segment (P = 0.0001)[Table 3] [Figure 1]. Table 3 Under area of ROC curve in predicting no-resolution of ST segment Figure 1 The receiver operating characteristic (ROC) curve for white blood cell, platelet distribution width and mean platelet volume to predict impaired reperfusion in patients treated with streptokinase.
DISCUSSION This study attempting to assess the resolution between hematologic (WBC, MPV and PDW) and clinical indexes of STEMI patients with resolution of ST segment treated with streptokinase. Other studies have investigated platelet count index in predicting no-reflow event on the basis of angiography criteria and have considered such high indexes as critical independent predictor in forecasting no-reflow event.[10,11] Regarding that recent studies have emphasized the role of ECG in assessing reperfusion and desired resolution of ST segment as successful myocardial reperfusion and have also considered establishment of microvascular circulation, however, patency of epicardium artery as more responsible event for MI[11,12,13] this study investigated the relation between resolution of ST segment and hematological, clinical indexes in patients.
Comparing the two groups, our study revealed that the group with lower resolution of ST segment enjoyed higher PDW, MPV and WBC values which are statistically significant. Ibrahim Brefeldin_A SUSAM et al. Reported that MPV is not associated Perifosine with post-intervention reperfusion in patients with STEMI treated with fibrinolysis. They suggested that MPV cannot be a marker of impaired reperfusion. In a study conducted by Pereg et al. indicated that higher MPV may correlates with thrombolysis failure in patients with STEMI.