Abstract

Abstract The mean platelet volume (MPV) is an easy, rapid and inexpensive laboratory parameter which basically mirrors platelet size. Due to the essential role of platelets in hemostasis, many studies have assessed the MPV value in patients with arterial and venous thrombotic disorders. These have then been summarized in some interesting meta-analyses and recent studies that will be discussed in this narrative review. Taken together, the currently available evidence suggests that the MPV may be substantially increased in concomitance with acute episodes of coronary artery disease, venous thromboembolism, portal vein thrombosis, stroke, erectile dysfunction and preeclampsia. In many of these conditions, an increased MPV value may also be associated with unfavorable outcomes. Despite these convincing findings, some important technical issues should be considered for improving the clinical usefulness of this measure. These essentially include anticoagulant, timing of sample collection, the sample storage conditions, the influence of the analytical techniques, the approaches used for its calculation, the accurate definition of reference ranges and diagnostic cut-offs, as well as the current lack of standardization, which makes data obtained with different techniques/analyzers poorly comparable. Provided that the impact of these variables can be abated or minimized, the MPV can gain a valuable role in the laboratory workout of many arterial and venous thrombotic disorders.

Highlights

  • Introduction on platelet structure and biologyPlatelets, known as thrombocytes, belong to the family of corpuscular elements that are physiologically present in blood

  • The recent meta-analysis performed by Pyo and colleagues concluded that mean platelet volume (MPV) is significantly increased in cancer patients compared to healthy controls, whilst its value significantly decreases in post-treatment patients [44]

  • Unlike Noris et al.’s conclusions, several lines of evidence attest that MPV may retain an important clinical value in patients with arterial and venous thrombotic disorders, whereby the pooled results of meta-analyses exploring platelet size in patients with coronary artery disease (CAD), venous thromboembolism (VTE), portal vein thrombosis, stroke, erectile dysfunction and preeclampsia converge to conclude that

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Summary

Introduction on platelet structure and biology

Known as thrombocytes, belong to the family of corpuscular elements that are physiologically present in blood. As regards additional vascular occlusive diseases, Shemirani et al recently published the results of a systematic review and meta-analysis of the literature, aimed at defining the role of MPV in patients with acute stroke [36] Their meta-analysis, encompassing 32 eligible articles, showed that MPV was significantly higher in patients with stroke compared to healthy controls (mean difference, 0.51 fL; 95% CI, 0.27–0.74 fL). The recent meta-analysis performed by Pyo and colleagues concluded that MPV is significantly increased in cancer patients compared to healthy controls (mean difference, 0.50 fL; 95% CI, 0.28–0.72 fL), whilst its value significantly decreases in post-treatment patients [44] This is an important information that contributes to explain the considerably higher burden of thrombotic disorders in patients with malignant diseases [45], as well as the putative interplay between platelet and cancer biology [46].

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