Effect Of Mean Platelet Volume Research Articles

Effect of mean platelet volume and platelet count on the prognosis of branch atheromatous disease.

The purpose of this study was to investigate the predictive value of mean platelet volume (MPV) and platelet count (PC) in branch atheromatous disease (BAD). This retrospective study included 216 patients with BAD-stroke within 48h of symptom onset. These patients were divided into good and poor prognosis groups according to their 3-month modified Rankin scale scores after discharge. Multiple logistic regression analysis was used to evaluate independent predictors of poor prognosis in BAD-stroke patients. Receiver-operating characteristic (ROC) analysis was used to estimate the predictive value of MPV and PC on BAD-stroke. Our research showed that a higher MPV (aOR, 2.926; 95% CI, 2.040-4.196; p<.001) and PC (aOR, 1.013; 95% CI, 1.005-1.020; p=.001) were independently associated with poor prognosis after adjustment for confounders. The ROC analysis of MPV for predicting poor prognosis showed that the sensitivity and specificity were 74% and 84.9%, respectively, and that the AUC was.843 (95% CI,.776-.909, p<.001). The optimal cut-off value was 12.35. The incidence of early neurological deterioration (END) was 24.5% (53 of 163), and 66% of patients in the poor prognosis group had END (33 of 50). Multiple logistic regression analyses showed that elevated MPV and PC were associated with the occurrence of END (p<.05). Our results suggested that an elevated MPV and PC may be important in predicting a worse outcome in BAD-stroke patients. Our study also demonstrated an independent association of MPV and PC with END, which is presumably the main reason for the poor prognosis.

The effects of mean platelet volume and red cell distribution width on prognosis in patients with myelodysplastic syndrome

Objective: In this study, the relationship between changes in mean platelet volume (MPV) and erythrocyte distribution width (RDW)&#x0D; with hematological response and survival in patients with myelodysplastic syndrome was investigated.&#x0D; Patients and Methods: Between 1 January 2011 and 31 December 2018, patient characteristics and hemogram results were evaluated&#x0D; during the treatment process among 158 patients diagnosed with myelodysplastic syndrome.&#x0D; Results: The mean age of the patients who were included in the study was 71.53±12.6 years. The MPV percentage change in the 2-year&#x0D; follow-up of the patients with and without hematological response was significant, at 0.022±0.11 (2.2%) in those who responded and&#x0D; at 0.069±0.15 (6.9%) in those who did not (p=0.049). Throughout the same period, the degree of RDW changes in the patients who&#x0D; died was 13.23±22.97, the degree in those who survived was 2.86±21.42, and the difference between the two groups was statistically&#x0D; significant (p=0.006).&#x0D; Conclusion: In patients diagnosed with myelodysplastic syndrome, MPV and RDW values can be considered inexpensive and simple&#x0D; laboratory markers that can be used in follow-ups and promising tests to predict both treatment response and survival in the early&#x0D; period and change treatment modalities.

The different predictive value of mean platelet volume-to-lymphocyte ratio for postoperative recurrence between non-muscular invasive bladder cancer patients treated with intravesical chemotherapy and intravesical chemohyperthermia.

The inflammatory response plays a potential role in postoperative recurrence in patients with non-muscular invasive bladder cancer (NMIBC). We aimed to investigate whether platelet-to-lymphocyte ratio (PLR), mean platelet volume to lymphocyte ratio (MPVLR), and the systemic immune-inflammatory index (SII) have prognostic values in NMIBC treated with conventional intravesical chemotherapy or intravesical Chemohyperthermia (CHT) and the differences between them. A retrospective cohort study was conducted on 222 patients with NMIBC treated with Intravesical Chemotherapy or Intravesical CHT between January 2016 and December 2020. Within a week before surgery, PLR, MPVLR, and SII were determined based on routine blood settling. The optimal cutoff value of each index was determined using the receiver operating characteristic curve, and various groups were categorized accordingly. The factors influencing the prognosis of NMIBC patients receiving various treatments were investigated using the Kaplan- Meier survival curve and the Cox regression model. 69 cases (46.3%) in the gemcitabine (GEM) group had tumor recurrence and 19 (12.8%) of them progressed to muscle-invasive bladder cancer (MIBC) or got metastasis, while 19 cases (26.0%) in the CHT group recurred and 2 (2.7%) progressed. Elevated PLR, MPVLR, and SII were associated with higher recurrence rates in the GEM group. Meanwhile, PLR and MPVLR were the independent risk factors. While in the CHT group, high PLR and SII were related to postoperative recurrence and none of them were independent risk factors. The preoperative clinical inflammatory indexes PLR, SII, and MPVLR have certain predictive value for the postoperative recurrence-free survival (RFS) in NMIBC patients treated with intravesical chemotherapy while PLR and SII can predict the prognosis of NMIBC patients treated with intravesical CHT, which indicates that intravesical CHT may stop tumor recurrence by influencing the effect of mean platelet volume on tumor growth through some unknown mechanisms.

Effect of Mean Platelet Volume to Platelet Count Ratio on Mortality in Peritoneal Dialysis.

Mean platelet volume to platelet count ratio (MPV/PC) has been found to be an independent risk factor for mortality in various diseases, including cardiovascular disease, cancer, and hemodialysis. We aimed to evaluate the association between MPV/PC and all-cause and cardiovascular (CV) mortality in peritoneal dialysis (PD) patients. We conducted a retrospective cohort study at a single center and enrolled 1473 PD patients who were catheterized at our PD center from January 1, 2006, to December 31, 2013. All patients were divided into four groups according to the quartiles of baseline MPV/PC levels and followed up until December 31, 2018. A total of 453 patients died, and 221 deaths were caused by cardiovascular disease during a median follow-up time of 48.0 (21.9-82.2) months. There was a significant interaction by age of association between MPV/PC level and all-cause mortality (P = 0.009), and multivariate Cox regression analysis showed that higher MPV/PC level was related to a decreased risk of all-cause and CV mortality in PD patients aged < 60 years (HR = 0.62, 95%CI = 0.40 - 0.96, P = 0.032; HR = 0.49, 95%CI = 0.26 - 0.93, P = 0.029, respectively), rather than in patients aged ≥ 60 years (HR = 1.37, 95%CI = 0.84 - 2.22, P = 0.208; HR = 1.50, 95%CI = 0.77 - 2.92, P = 0.237, respectively). Our results indicated that low MPV/PC level was an independent risk factor for all-cause and CV mortality in PD patients aged less than 60 years.

The relationship between mean platelet volume and the mortality of patient severe head trauma; first study

Background Prediction of mortality in a patient with head trauma is essential. In this study, the effect of mean platelet volume (MPV) on the mortality rate of patients with severe head trauma was studied. Material and methods The relationship between mortality and mean platelet volumes of patient with cranial trauma was retrospectively analyzed. Results 43 patients with head trauma were admitted to the intensive care unit during the study period. While 17 patients died (Group I), 26 patients survived (Group II). Cox regression analysis showed that late MPV (at exitus or discharged date), WBC at admission, and age increase the mortality rate 1,770, 1,202, 1,052 times, respectively. Conclusions The present study shows that MPV may be a useful predictor of mortality in patients with severe head trauma.

Interaction of Lipids, Mean Platelet Volume, and the Severity of Coronary Artery Disease Among Chinese Adults: A Mediation Analysis

ObjectiveCurrently, coronary artery disease (CAD) is regarded as one of the leading global disease burdens. Evidence proved that platelet activation in dyslipidemia induced CAD, however, their interaction has not been well-established in vivo. This study aims to assess the mediation effects of mean platelet volume (MPV) in lipids and the severity of CAD.MethodsWe prospectively enrolled 5,188 consecutive subjects who underwent coronary angiography between 2015 and 2020. Participants were grouped according to their CAD events, which was defined as stenosis ≥50% in at least one coronary artery, and whose severity was evaluated by the Gensini score (GS). A lipid index was drawn by principal component analysis to weight related lipid parameters including total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), non-HDL-C, apolipoprotein (apo) A1 B. The interaction of lipids and MPV in atherosclerosis was evaluated by the mediation analysis.ResultsLipid index increased with elevated GS irrespective of statin status (not on statin: β = 0.100, p < 0.001; on statin: β = 0.082, p < 0.001). Multiple linear regression indicated positive correlation between MPV and GS after adjustment (β = 0.171, p < 0.001). Subjects in the highest MPV tertile had higher levels of atherogenic lipid parameters and lipid index (p < 0.001). The adjusted odds ratios were greater among individuals undergoing statin medications who had high GS and higher MPV levels by elevated lipid index tertiles [1.168 (0.893–1.528) vs. 2.068 (1.552–2.756) vs. 1.764 (1.219–2.551)]. The combination of lipid index and MPV provided better prediction for high GS than individual lipid index or MPV, as shown by receiver-operating characteristic (ROC) curves (areas under ROC curves were 0.700 and 0.673 in subjects on or not on statin treatment, respectively). Significantly, mediation analysis revealed the mediation interaction of lipid index on GS by MPV, whose effect size reached 20.71 and 20.07% in participants with or without statin medications.ConclusionThe increased risk of dyslipidemia on CAD was partly enhanced by elevated MPV levels, whose mediating effect was around 20%.

Evaluation of mean platelet volume, neutrophil/lymphocyte ratio and platelet / lymphocyte ratio relationship with disease severity and metabolic syndrome in patients with psoriasis vulgaris

Aim: Psoriasis is one of the diseases caused by chronic inflammation. It is associated with a number of comorbidities (metabolic syndrome, cardiovascular disease, obesity, non-alcholic fatty liver...). Recently, mean platelet volume (MPV), neutrophil lymphocyte ratio (NLR) and platelet lymphocyte ratio (PLR) were found to be related to systemic inflammation. At the end of this study, the risk of metabolic syndrome in psoriasis will be evaluated and the effect of MPV, NLR, PLR levels will be determined on predicting metabolic comorbidities in psoriasis patients.Material and Methods: This research was planned prospectively. The study consisted of 40 patients with psoriasis vulgaris and 40 healty control group which was similar in age and gender . Patients' informations were recorded and blood pressure, height, weight values were measured. Hemogram parameters, biochemistry values were determined.Results: The count of neutrophiles was higher in the psoriasis; but disease severity and neutrophil count were not related each other. According to our study, MPV values, high density lipoprotein (HDL), fasting blood glucose and body mass index (BMI) were meaningful findings in estimating the development of metabolic syndrome. Conclusion: The use of neutrophil activation markers in addition to neutrophil count in patients with psoriasis may be useful in determining disease severity and activation. In the follow-up of patients with psoriasis, fasting glucose, HDL, BMI value and MPV can help predicting possibility of metabolic syndrome and cardiovascular diseases that may develop in these patients.

Is Migraine an MPV-Related Disease? An Observational Study of Polish Neurological Patients.

Many studies have found correlations between abnormal MPV and clinical reactivity in a variety of diseases. In the present paper, we sought MPV-related neurological diseases that are less frequently reported in the literature. The electronic medical records of 852 neurological patients with mean platelet volume (MPV) measurements (F = 45%, age = 55.7 ± 18.7, 8–104) were searched after the patients had received a diagnosis of a neurological disease (new and old episodes) according to the nine classes of the International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10). A set of consecutive statistical methods (i.e., cluster analysis, segmented regression, linear correlation, propensity score matching, and mixed effects Poisson regression) were used to establish a link between MPV and neurological disease. A statistically significant (p < 0.05) relationship with MPV was found only in pain syndrome patients, with seven out of eight clinically diagnosed migraine episodes. With all other ICD-10 classes of neurological diseases, the effect of MPV was found to be nonsignificant (p > 0.05). MPV may implicate a clinical relationship with pain syndrome and migraine episodes. More complex statistics could help analyse data and find new correlations.

Effects of mean platelet volume and platelet counts on peripheral biodegradable stent restenosis

Aim: Thrombocytes play a key role in atherosclerosis and acute vascular events. The purpose of this study is to investigate the association between mean platelet volume (MPV), platelet counts as well as other hematological parameters and biodegradable stent re-stenosis.Methods: 53 patients who underwent percutaneous biodegradable peripheral stent placement procedure were included in this retrospective cohort study. Blood samples were collected a day before the operation. Patients were followed for a mean of 6 months and Doppler ultrasonography (DUSG) was performed for control examination. According to the DUSG results, patients were divided into two groups: Group 1 included patients with ≥50% in-stent re-stenosis and Group 2, with &lt;50% in-stent re-stenosis. Results: The mean age of the patients was 58.1 (6.7) years. 6 (11.3%) patients were female and 47 (88.7%) patients were male. Eight (15%) had iliac artery and 45 (84.9%) had superficial femoral artery stenosis. Doppler US reports showed that 11 (20.8%) patients had ≥50% in-stent re-stenosis (Group 1). Re-stenosis rates were higher at younger ages (P=0.020). There was no statistically difference between the groups in terms of gender (P=0.636), MPV (P=0.210), PLT counts (P=0.129) or any other hematologic parameters.Conclusion: Several studies have shown that some blood parameters, especially MPV, are effective on coronary and peripheral stent stenosis. In our study, we found that none of the hematologic or common blood parameters can predict biodegradable stents re-stenosis.

The Effects of vitamin B12 and folic acid deficiency on hemogram parameters in children

Objective: According to numerous studies, bicytopenia, pancytopenia, or isolated thrombocytopenia and anemia patients have folic acid (folate) and vitamin B12 (B12) deficiency. The purpose of this study is to analyze the effects of folate and B12 deficiency in childhood on several haemogram parameters such as platelet (PLT), mean platelet volume (MPV), hematocrit (HCT), mean corpuscular volume (MCV), and white blood cell (WBC) count.&#x0D; Materials and Methods: The retrospective study included children who had applied to the pediatric outpatient clinic between 2015 and 2017. Patients were divided into 3 groups according to serum B12 and folate status. The results were evaluated by statistical methods.&#x0D; Results: PLT and WBC levels of the folate and B12 deficiency group were found to be lower than the control group (p=0.015, p&lt;0.001 respectively), and their MPV and HCT levels were higher (p: 0.015, p&lt;0.001 respectively). MCV levels, however, were not different (p&gt;0.05). No effect of PLT and MCV on folate levels was seen. Similarly, any effects of MPV, PLT and MCV independent variables on B12 levels were not observed. Although platelet and leukocyte count was decreased in folate and B12 deficiency, thrombocytopenia and leukopenia were observed only three patients.&#x0D; Conclusion: Although peripheral blood cell lines are not always seen low during folate and B12 deficiency, and there is not obvious anemia and MCV highness at a patient with neurological and psychological symptoms, folate and B12 deficiency should be thought if there are leukocyte and thrombocyte levels lower than mean reference values.

High mean platelet volume to platelet count ratio as a predictor on poor outcomes after CABG.

To determine the effect of mean platelet volume (MPV) to platelet count (PC) ratio on postoperative poor outcomes, early mortality and long-term survival rate in patients undergoing CABG. Between February 2016 and September 2018, all patients undergoing CABG in our department were retrospectively reviewed. A total of 213 consecutive patients were included in the study. Mean age was 61.5 ± 9.7years and mean follow-up of all patients was 1.4 ± 0.5years. All patients were divided into two groups as high and low MPV/PC ratio in terms of 3.825 of cut-off point. 72 patients had a high MPV/PC ratio, whereas, 141 patients had low MPV/PC ratio. The rates of reoperation for early vein-graft occlusion, low cardiac output syndrome and respiratory complication were significantly higher in group 1 (p = 0.03, 0.04 and 0.01). The mean hospital length of stay was higher in group 1 (p = 0.03). MPV/PC ratio for reoperation for early vein-graft occlusion; MPV and ejection fraction for low cardiac output syndrome; hyperlipidemia, chronic renal failure history and MPV/PC ratio for sepsis; male gender, CRF history and CPB time for atrial fibrillation; age, congestive heart failure history, myocardial infarction history and CPB time for the early mortality were found to be independent predictors. Peripheral arterial diseases, USAP and MPV/PC ratio were found to be independent predictors for the late mortality. A high MPV/PC ratio is associated with early vein-graft occlusion and poor postoperative outcomes in the early period after CABG. Furthermore, it has a negative effect on late survival.

The Relationship Between Mean Platelet Volume and In-Hospital Mortality in Geriatric Patients with ST Segment Elevation Myocardial Infarction Who Underwent Primary Percutaneous Coronary Intervention

Objective: We planned to investigate the effect of mean platelet volume (MPV) on in-hospital mortality and coronary risk factors in geriatric patients with ST segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). Methods: We enrolled 194 consecutive STEMI patients. The study population was divided into two groups on the basis of admission MPVs. The high-MPV group (n=49) included patients in the highest tertile (&gt;8.9 fL), and the low-MPV group (n=145) included patients with a value in the lower two tertiles (≤8.9 fL). Clinical characteristics, in-hospital mortality, cardiovascular risk factors, and outcomes of primary PCI were analyzed. Results: The patients in the high-MPV group were older, more of them had three-vessel disease, and they had higher in-hospital mortality. Patients with in-hospital death were older, had higher Gensini score, creatinine concentration, and MPV, and had lower HDL cholesterol concentration. MPV, age, HDL cholesterol concentration, creatinine concentration, and Gensini score were found to be independent predictors of in-hospital death. Conclusion: These results suggest that high admission MPV levels are associated with increased in-hospital mortality in geriatric patients with STEMI undergoing primary PCI.

The Predictive Effect of Mean Platelet Volume (MPV) and Neutrophil-to-Lymphocyte Ratio (NLR) on the Functional Outcome of Acute Ischemic Stroke

AbstractBackground: Inflammation has been reported to constitute a major component of ischemic stroke pathology. Nevertheless, to the best of our knowledge, no previous studies have inves-tigated the NLR and MPV values in the cases of stroke stratified by subtype.Aim of Study: The aim of our study is to predict the role MPV and NLR in short-term outcome in patients with ischemic stroke and their association to stroke severity, stroke risk factors and functional outcome.Patients and Methods: This prospective cross sectional study directed on 125 patients with first time acute ischemic stroke. All members exposed to full history taking, detailed clinical examination and neurological checking. Brain imaging was performed after hospital admission. Blood tests were drawn for appraisal of the mean platelet volume (MPV) (in FL) and the neutrophil-lymphocyte ratio (NLR).Results: Our results revealed that the mean value for NLR was higher in dead patients with ischemic stroke. By ROC curve, higher NLR at admission predicted the mortality than MPV. We found higher NLR levels in patients with more severe stroke. However, We did not observe a significant correlation between the MPV, the stroke severity, and outcome.Conclusion: NLR was an independent risk factor and serves as a sensitive index for the prognosis of ACI patients. Further well-designed and large-scale prospective studies are necessary to evaluate platelet MPV and NLR for observing patients with cerebral infarction among different territories of Egypt and for stroke subtypes.

Predictive Effect of Mean Platelet Volume in Patients with Portal Vein Thrombosis: A Meta-analysis of Case-control Studies.

Mean platelet volume (MPV) is an early marker of platelet activation. Larger platelets, compared to small ones, increase platelet adhesion and aggregation, and present a higher thrombotic activity. Some studies have explored the association between MPV and the morbidity of portal vein thrombosis (PVT). The aim of this study was to evaluate the predictive effect of MPV in patients with PVT by a meta-analysis. We searched Pubmed, Web of Science, SCOPUS, OVID, CNKI and CBMD from database inception to September 13,2017. Seven studies in accordance with selection criteria were included. The extraction of basic data was independently conducted by two reviewers. The mean difference in MPV between PVT patients and controls were pooled with weighted mean difference (WMD) and 95% confidence interval of 0.88 fl (95% CI: 0.61-1.15). A random-effect model was chosen for an obvious heterogeneity in the pooling (Chi-square=27.12, df=6, P<000l, I2=77.9%). The sources of heterogeneity were from the difference of primary disease of participants and portal vein diameter. Taken together, our results reveal that MPV is a predictive indicator in patients with PVT.

Analysis of mean platelet volume and red blood cell distribution width in recurrent epistaxis

ObjectivesRecurrent epistaxis is one of the most common causes of emergency department visits. Although several localized and systemic conditions has been described, the exact cause is unknown in the majority of cases. In our study, we aimed to determine the effect of mean platelet volume (MPV) and red blood cell distribution width (RDW) levels on recurrent epistaxis. MethodOne hundred and thirty six patients with recurrent epistaxis and 170 healthy cases as control group were included in the study. Demographic data, vital signs and the results of complete blood counts were recorded. The patients who had clinical conditions that might affect the levels of MPV or RDW, were excluded. MPV and RDW levels were compared between the two groups. ResultsThe median level of MPV was 7.6 fL (IQR25–75%: 7.1–8.4) in the study group and 8.2 fL (IQR25–75%: 7.8–8.9) in the control group (p < 0.001). The median levels of RDW were found in the patient and control groups in order %15.4 (IQR25–75%: 14.5–15.4) and %14.3 (IQR25–75%: 13.4–15.4) (p < 0.001). Systolic blood pressure, leukocyte count, age, sex, RDW and MPV levels that were variables with p levels<0.2, were included in the multivariate analyses. It was determined that high RDW levels increased epistaxis (p < 0.001; OR:1.89 [95% CI:1.53–2.33]) and high MPV levels decreased epistaxis (p < 0.001; OR:0.54 [95% CI:0.39–0.72]). ConclusionLow MPV and high RDW levels caused an increased bleeding tendency in patients with recurrent epistaxis. Although exact mechanism is not known, referring those patients for the assessment of etiologic causes would be proper.

Association of polycyclic aromatic hydrocarbons exposure with atherosclerotic cardiovascular disease risk: A role of mean platelet volume or club cell secretory protein.

Inflammation may play an important role in the association between exposure to polycyclic aromatic hydrocarbons (PAHs) and atherosclerotic cardiovascular disease (ASCVD) risk. However, the underlying mechanisms remain unclear. To investigate the association of PAHs exposure with ASCVD risk and effects of mean platelet volume (MPV) or Club cell secretory protein (CC16) on the association. A total of 2022 subjects (689 men and 1333 women) were drawn from the baseline Wuhan residents of the Wuhan-Zhuhai Cohort study. Data on demography and the physical examination were obtained from each participant. Urinary monohydroxy PAH metabolites (OH-PAHs) levels were measured by a gas chromatography-mass spectrometry. We estimated the association between each OH-PAHs and the 10-year ASCVD risk or coronary heart disease (CHD) risk using logistic regression models, and further analyze the mediating effect of MPV or plasma CC16 on the association by using structural equation modeling. The results of multiple logistic regression models showed that some OH-PAHs were positively associated with ASCVD risk but not CHD risk, including 2-hydroxyfluoren (β=1.761; 95% CI: 1.194-2.597), 9-hydroxyfluoren (β=1.470; 95% CI: 1.139-1.898), 1-hydroxyphenanthrene (β=1.480; 95% CI: 1.008-2.175) and ΣOH-PAHs levels (β=1.699; 95% CI: 1.151-2.507). The analysis of structural equation modeling shows that increased MPV and increased plasma CC16 levels contributed 13.6% and 15.1%, respectively, to the association between PAHs exposure and the 10-year ASCVD risk (p<0.05). Exposure to PAHs may increase the risk of atherosclerosis, which was partially mediated by MPV or CC16.

Predictive and prognostic role of mean platelet volume in patients with first-ever acute ischemic stroke.

Objective:To investigate any possible effects of mean platelet volume (MPV) on short-term stroke prognosis and functional outcome in patients with first-ever acute ischemic stroke (FEAIS).Methods:This retrospective cross-sectional study included 798 FEAIS patients admitted to the emergency department of a tertiary care hospital in Adiyaman, Turkey between January 2013 and June 2015. The data were evaluated according to whether alive or dead, MPV levels, modified Rankin scale (MRS) scores, National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into 3 groups based on MPV level as 4.4-7.4 fL, 7.5-10.4 fL, higher than 10.4 fL.Results:A total of 250 patients with FEAIS were included in the study. In both those who survived and those who died, the area under the curve related to hospitalization days, time interval of venipuncture (TIV), and MPV measurements was not statistically significant (p>0.05). The 3 MPV groups showed no significant differences in terms of MRS score, median NIHSS score, hospitalization, and TIV. In subgroups based on MRS scores, there were no statistically significant differences according to median latency (p=0.087), median hospitalization (p=0.394), TIV (p=0.201), and MPV levels (p=0.847). Furthermore, there were no differences in MPV levels between the MRS based groups (p=0.527).Conclusion:The results showed that MPV was not a significantly associated and reliable marker for the prediction of prognosis or functional outcome of FEAIS attack.

English

English

An increase in mean platelet volume from baseline is associated with mortality in patients with severe sepsis or septic shock.

IntroductionMean platelet volume (MPV) is suggested as an index of inflammation, disease activity, and anti-inflammatory treatment efficacy in chronic inflammatory disorders; however, the effect of MPV on sepsis mortality remains unclear. Therefore, we investigated whether the change in MPV between hospital admission and 72 hours (ΔMPV72h-adm) predicts 28-day mortality in severe sepsis and/or septic shock.MethodsWe prospectively enrolled 345 patients admitted to the emergency department (ED) who received standardized resuscitation (early goal-directed therapy) for severe sepsis and/or septic shock between November 2007 and December 2011. Changes in platelet indices, including ΔMPV72h-adm, were compared between survivors and non-survivors by linear mixed model analysis. The prognostic value of ΔMPV72h-adm for 28-day mortality was ascertained by Cox proportional hazards model analysis.ResultsThirty-five (10.1%) patients died within 28 days after ED admission. MPV increased significantly during the first 72 hours in non-survivors (P = 0.001) and survivors (P < 0.001); however, the rate of MPV increase was significantly higher in non-survivors (P = 0.003). Nonetheless, the difference in the platelet decline rate over the first 72 hours did not differ significantly between groups (P = 0.360). In multivariate analysis, ΔMPV72h-adm was an independent predictor of 28-day mortality, after adjusting for plausible confounders (hazard ratio, 1.44; 95% confidence interval, 1.01–2.06; P = 0.044).ConclusionsAn increase in MPV during the first 72 hours of hospitalization is an independent risk factor for adverse clinical outcomes. Therefore, continuous monitoring of MPV may be useful to stratify mortality risk in patients with severe sepsis and/or septic shock.

Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis.

Large platelets with high haemostatic activity may lead to increased platelet aggregation.. Mean platelet volume (MPV), an indicator of platelet reactivity, may emerge as a prognostic marker in patients with coronary artery disease (CAD). It was the objective of this study to conduct a systematic review and meta-analysis to assess prognostic effects of MPV on cardiovascular events (CVE) in CAD patients. We searched MEDLINE and SCOPUS from inception to January 2, 2014. All studies that reported MPV and the incidence of cardiovascular events in CAD patients were included. Two reviewers independently extracted the data. A random-effects model was applied for pooling the mean difference of MPV between patients with vs without CVE. Among 30 eligible studies, eight studies reported mean difference of MPV between CVE groups, 11 studies reported MPV dichotomous into high vs low MPV groups, and 11 studies reported both. The pooled mean difference was 0.69 fL (95 %CI = 0.36, 1.01), i. e. patients with CVE had a MPV about 0.69 fL higher than non-CVE. Patients with higher MPV were about 12 % more likely to die than patients with lower MPV (RR 1.12; 95 %CI = 1.02-1.24). However, pooling these effects was based on high heterogeneity and the source of heterogeneity could not be identified. This might be explained by many differences among included studies (e. g. study population, outcomes of interest, analysate, time between blood collection and MPV analysis, etc). These findings suggest that MPV may be a useful prognostic marker in patients with CAD.