Mean Platelet Volume: A Prognostic Biomarker after Percutaneous Coronary Interventıon

Abstract

I read with great interest the recent report by Goncalves et al 1 Goncalves S.C. Labinaz M. May M.L. Glover C. Froeschi M. Marquis J.F. O'Brien E. Shukla D. Ruchin P. Sokur D. Ha A. So D. Usefulness of mean platelet volume as a biomarker for long-term outcome after percutaneous coronary intervention. Am J Cardiol. 2011; 107: 204-209 Abstract Full Text Full Text PDF PubMed Scopus (74) Google Scholar on the usefulness of mean platelet volume (MPV) as a prognostic biomarker after percutaneous coronary intervention (PCI). In this study, the investigators assessed the prognostic importance of MPV as a biomarker for long-term outcomes after PCI and demonstrated that the presence of higher MPV values and diabetes mellitus is a strong independent predictor of long-term outcomes after PCI. This is in association with the findings of Yang et al, 2 Yang A. Pizzulli L. Lüderitz B. Mean platelet volume as marker of restenosis after percutaneous transluminal coronary angioplasty in patients with stable and unstable angina pectoris. Thromb Res. 2006; 117: 371-377 Abstract Full Text Full Text PDF PubMed Scopus (90) Google Scholar who found that MPV was a marker of restenosis after PCI. Along with these findings, in a recent study, Yılmaz et al 3 Yılmaz M.B. Cihan G. Guray Y. Guray U. Kisacik H.L. Sasmaz H. Korkmaz S. Role of mean platelet volume in triaging acute coronary syndromes. Thrombolysis. 2008; 26: 49-54 Crossref PubMed Scopus (76) Google Scholar evaluated the role of MPV in patients with acute coronary syndromes and demonstrated that MPV is significantly higher in patients with acute coronary syndromes than in those with stable coronary heart disease, and furthermore, it was shown that MPV values were significantly higher in patients requiring urgent PCI. In fact, platelets are quite heterogenous blood elements, diverging in terms of size, density, and reactivity. 4 Karpatkin S. Heterogeneity of human platelets II. Functional evidence suggestive of young and old platelets. J Clin Invest. 1969; 48: 1083-1087 Crossref PubMed Scopus (242) Google Scholar Platelet size has been shown to reflect platelet activity, 5 Thompson C.B. Jakubowski J.A. Quinn P.G. Deykin D. Valeri C.R. Platelet size and age determine platelet function independently. Blood. 1984; 63: 372-375 Google Scholar and along with this finding there is evidence that MPV is an important biologic variable and that immature platelets have larger MPV values with higher thrombotic potential. 6 Martin J.F. Platelet heterogeneity in vascular disease. in: Martin J.F. Trowbridge E.A. Platelet Heterogeneity Biology and Pathology. Springer-Verlag, London1990: 205-206 Crossref Google Scholar On the basis of these findings, increased MPV may reflect more aggressive platelet behavior and that larger and hyperactive platelets might be accelerating the formation and propagation of intracoronary thrombus, leading to the occurrence of clinical events. Usefulness of Mean Platelet Volume as a Biomarker for Long-Term Outcomes After Percutaneous Coronary InterventionAmerican Journal of CardiologyVol. 107Issue 2PreviewLarger size platelets have enhanced reactivity. The mean platelet volume (MPV) is a marker of platelet activation and is usually measured as part of blood testing. The aim of the present study was to investigate the utility of the MPV as a biomarker in prognosticating the long-term outcomes after percutaneous coronary intervention (PCI). The baseline MPV values from consecutive patients undergoing PCI were screened. Of the 1,432 patients, the composite primary end point of mortality or myocardial infarction at 1 year occurred in 80 (5.6%). Full-Text PDF