Higher Mean Platelet Volume Levels Research Articles

Elevated mean platelet volume is associated with poor short-term outcomes in hepatitis B virus-related acute-on-chronic liver failure patients

It has been shown that mean platelet volume (MPV) can be used as a prognostic biomarker in some chronic diseases. The aim of the present study is to investigate the possible association between MPV and clinical outcome and prognosis in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) within 4 weeks. This study included 64 patients with HBV-ACLF, 19 chronic hepatitis B (CHB) patients, 27 patients with hepatitis B-related cirrhosis (CR, Child-Pugh A/B), 51 healthy subjects (healthy controls [HC]). The complete blood counts and biochemical examination of blood were obtained after 12h of fasting. In the ACLF group, the relationships between the prognosis and the MPV were analyzed. At baseline, a statistically significant increase in MPV was shown in patients with ACLF (median 9.5, range 7.1-14.1) compared with HC (8.0, 7.2-11.9, P<0.001), CR (8.4, 5.9-11.1, P<0.001) and CHB (8.3, 7.3-12.0, P<0.001). The MPV value was positively correlated with model of end-stage liver disease (MELD) score and international normalized ratio (INR). The MPV level was significantly increased in nonsurvivors than survivors. High MPV level showed a significantly lower survival rate (P=0.001). Multivariate logistic regression analysis showed that only MPV level was independent factor predicting poor short-term outcomes. MPV values at presentation were higher among nonsurvivors than survivors, and this parameter was well correlated with liver function parameters and may be used as a predictor for 4-week mortality rate in patients with HBV-ACLF.

Elevated mean platelet volume is associated with silent cerebral infarction.

The presence of silent cerebral infarction (SCI) increases the risk of transient ischaemia attack, symptomatic stroke, cardiovascular disease and dementia. Mean platelet volume (MPV) is a surrogate marker of activated platelets and is considered a link between inflammation and thrombosis. In addition, MPV is a risk predictor for cardiovascular disease, stroke and overall vascular mortality. The purpose of the study was to assess the MPV levels in SCI patients. A cross-sectional study was conducted to evaluate the association between MPV and SCI in 2215 subjects (1385 men and 830 women). The participants with SCI had higher MPV levels than those without SCI (10.4 ± 1.3 fL vs. 9.2 ± 1.2 fL; P < 0.001). Moreover, the subjects with a high MPV had a higher prevalence of SCI. Multivariate logistic regression analyses revealed that the odds ratios and 95% confidence intervals for SCI according to MPV quartiles were 1.000, 2.131 (1.319-3.444), 3.015 (1.896-4.794), 7.822 (4.874-12.554) respectively (P < 0.001). MPV is a novel index for SCI regardless of classical cardiovascular risk factors.

OP-235 Increased Mean Platelet Volume is Associated with Left Atrial Spontaneous Echo Contrast in Patients With Atrial Fibrillation

Objective: The accurate underlying pathogenic mechanism behind spontaneous echo contrast (SEC) is complex and poorly understood. The aim of this study is to characterize the relationship between mean platelet volume (MPV) and left atrium SEC. Material and methods: We screened retrospectively the records of 172 patients with AF in whom transesophageal echocardiography was performed. Patients were categorized according to the presence of the left atrial SEC. Group 1 was consisted of patients with AF and left atrial SEC (-), and group 2 was consisted of patients with AF and left atrial SEC (+). Basal demographic, laboratory and echocardiographic features of the patients were compared between two groups. Multivariate regression analysis was established to identify the independent association between MPV levels and other potential variables. Results: The study group included 105 men (61%) and 67 women (39%), and the mean age of the patients was 64.48 ± 13.90 years. Group 1 was consisted of 97 patients (70 (72.2%) men and mean age 61.90 ± 15.75 years) and Group 2 was consisted of 75 patients (35 (46.7%) men and mean age 67.82 ± 10.23 years). We observed that SEC (+) patients had higher MPV values (8.94 ± 0.98 fL vs. 8.52 ± 1.15 fL, p value 0.012). The mean MPV values for 8.65 fL for patients with SEC (+), 8.93 fL for patients with SEC (++) and 9.15 fL for SEC patients with (+++). (p value between groups was 0.038). In multivariate regression analysis, only the association between MPV level and the degree of SEC remained statistically significant (β= 0.165, p = 0.042). Conclusion: We conclude that AF patients with SEC have significantly higher MPV levels compared with AF patients without SEC.

Mean Platelet Volume Levels in Children With Adenoid Hypertrophy

Adenoid hypertrophy (AH) is a common disorder in children, resulting in chronic nasal congestion. This chronic congestion should be evaluated carefully because it can lead to chronic upper airway obstruction. Many authors have suggested that increased nasal resistance to respiration may cause disturbances in the pulmonary ventilation and carry the risk of cardiopulmonary diseases. Mean platelet volume (MPV) is a marker of platelet function and is positively associated with indicators of platelet activity. Mean platelet volume is an indicator of larger and more reactive platelets and has been shown to be increased in patients with vascular disease, including peripheral, pulmonary, and coronary artery disease. Recently, MPV levels have also been shown to be increased in patients with severe obstructive sleep apnea, and marked nasal septal deviation. Moreover, increased MPV has also been shown to have a prognostic role in cardiovascular disease. We investigated whether MPV is higher in patients with AH and whether higher MPV levels can be reduced by adenoidectomy. To the best of our knowledge, this is the first study to investigate MPV in patients with AH. Our results suggest that MPV, a determinant of platelet activation, is elevated in patients with AH and adenoidectomy is an effective therapeutic measure in such patients. Increased platelet activation may be related to an increase of cardiopulmonary risk in patients with AH.

Mean platelet volume (MPV) may simply predict the severity of sepsis in preterm infants.

To evaluate the efficacy of serial mean platelet volume (MPV) measurements in diagnosis and followup of sepsis and to compare its effectiveness with C-reactive protein (CRP) and interleukin-6 (IL-6) in sepsis. Preterm infants, whose gestational age and weight were matched to each other, were grouped as control (n = 100) and sepsis (n = 91). Platelet indices (MPV, PDW, platelet count), CRP, and IL-6 levels were measured for the control group and on the day of diagnosis (1st day), 3rd, and 7th days of the sepsis group. There were significant differences between the control and sepsis group in terms of platelet count and MPV/PDW levels (p < 0.05). No significant changes were found in either platelet count or MPV and PDW of infants between early and late onset sepsis, nor between culture proven and non proven sepsis, nor among different infectious agents (gram positive/negative and fungal infections) (p > 0.05). Additionally, non-survivors with sepsis had higher levels of MPV and PDW during sepsis episodes on consecutive days (p < 0.05), in contrast to lower platelet counts in non-survivors (p < 0.05). Moreover, a positive correlation was found between MPV and IL-6 and CRP. A MPV value of 10.35 fL was identified as the cut off value in patients probably resulting in sepsis with a sensitivity of 97.8% and specificity of 78.7% (AUC = 0.949; p < 0.001), and a MPV value of 10.75 fL was determined as the cut off value in patients possibly resulting in death at diagnosis with a sensitivity of 95.2% and a specificity of 84.9% (AUC = 0.944; p < 0.001). The mean platelet volume can be used in addition to CRP and IL-6 at both diagnosis and follow-up of sepsis and the response of antimicrobial treatment.

Higher mean platelet volume level in patients with pulmonary embolism

Higher mean platelet volume level in patients with pulmonary embolism

Correlation of the Coronary Severity Scores and Mean Platelet Volume in Diabetes Mellitus

It is known that mean platelet volume (MPV) increases during acute coronary syndrome. However, there are conflicting data about the importance of MPV in patients with stable coronary artery disease (CAD). This study aimed to assess relationship between MVP and the severity of coronary atherosclerosis in patients with diabetes mellitus (DM), stable CAD and normal left ventricular ejection fractions. Thirty-three DM and 46 nonDM patients with stable CAD diagnosed by selective coronary angiography were included in the study. All angiographic variables pertinent to Gensini score (GS) and Syntax score (SS) calculation were computed by two experienced interventional cardiologists. All patients underwent echocardiographic examination. MPV and other biochemical markers were measured on admission. All patients were evaluated and it was found that both scoring systems are correlated with MPV (GS: r=0.373, p<0.001; SS: r=0.385, p<0.001). DM and nonDM groups were severally evaluated, it was found that the correlation between MPV and GS and SS increased in DM patients (GS: r=0.638, p<0.001; SS: r=0.624, p<0.001); however, no differences were identified in nonDM patients (GS: r=0.124, p=0.410; SS: r=0.124, p=0.411). It is thought that high MPV levels may be an effective marker in determining the severity of CAD in patients with DM. And the high MPV level may be related with CAD pathophysiology in DM patients.

Fibrosis Stage and Lack of Response to Interferon/Ribavirin-based Therapy Are Associated with Higher Mean Platelet Volume Levels in Patients with Chronic Hepatitis C

Purpose: There is a paucity of data regarding the role of mean platelet volume (MPV) in chronic liver diseases; MPV may be associated with the severity of liver disease in patients with chronic hepatitis C (HCV). The aims of this study are to assess the relationship of MPV with liver grade and stage, as well as to assess whether virological response is associated with lower MPV. Methods: A retrospective cohort study of MPV in 328 patients with chronic HCV, treated with interferon/ribavirin-based therapy was performed. Demographics, laboratory data including initial and final (end of study period) MPV, as well as pre-treatment liver biopsies, evaluated by Batts and Ludwig grading system were collected. Responders (R) were defined as a sustained virological responder (SVR) or end-of-treatment response (ETR), and non-responders (NR) were defined as non-responder or documented relapser. Statistical analysis was performed using student's T test. Results: Our cohort was 93% male; majority were white (70%), with a mean age of 57.7 years (yr). Response occurred in 46% of HCV patients, with significantly more African Americans in NR than R (39% vs 14%), but with no differences between the groups' laboratory values of ALT, alkaline phosphatase, total bilirubin, INR or platelet levels. Importantly, in the 151 R and 177 NR, the R patients were younger ([R 52.5 years vs NR 61.4 years [p=0.001]). The average follow-up for R and NR was 5.3 years and 6.2 years, respectively (p=0.005). Liver biopsies were available in 206 patients (62%) (R, n=92 vs NR, n=114). Initial MPV was higher in stage 3 and 4 disease (11.2 ± 1.2), vs stage 1 and 2 disease (10.6 ± 0.95) (p=0.0004). Similar findings were noted with grade of inflammation ([grade 1 and 2, initial MPV, 10.9 ± 0.99] versus [grade 3 and 4, 11.1 ± 1.2 [p=0.02]) Furthermore, baseline and last MPV levels differed between R and NR (Table 1).Table 1Conclusion: Virological response to interferon/ribavirin therapy is associated with decreasing MPV, while lack of response revealed no significant changes in MPV. Significant fibrosis and inflammation are associated with higher MPV in patients with chronic hepatitis C. MPV may be a useful biomarker of severity of liver disease in this population with chronic hepatitis C.

Stroke Prevention in Patients with Non-valvular Atrial Fibrillation: New Insight in Selection of Rhythm or Rate Control Therapy and Impact of Mean Platelet Volume

The aim of this study was to determine the impact of mean platelet volume (MPV) on the strategy for treatment of atrial fibrillation (AF) with respect to stroke prevention. MPV was analyzed in 265 patients with AF who were undergoing treatment using rhythm or rate control. The primary endpoint was ischemic stroke or a transient ischemic attack (TIA) event. Kaplan-Meier analysis revealed a significantly higher stroke rate in the rate control group compared to the rhythm control group. A significantly higher stroke rate was observed in the higher tertile MPV group (≥7.9 fL) compared to the lower tertile MPV group (<7.3 fL). When the MPV cut-off level was set to 7.85 fL using the receiver operating characteristic curve, the sensitivity was 80.0% and the specificity was 70.4% for differentiating between the group with stroke and the group without stroke. In the Cox proportional hazard analysis, after adjusting for sex, treatment strategy for AF, high MPV level, antithrombotic treatment, and high CHADS2 score, higher MPV, rate control strategy for treatment of AF, and high CHADS2 score were found to be independent predictors of stroke risk. In addition, patients with AF who were treated using rate control had high stroke risk with an MPV over 7.85 fL and high CHADS2 score. The results of this study demonstrate that the MPV and the rate control strategy for treatment of AF were predictive markers for stroke; its predictive power for stroke was independent of female sex and high CHADS2 score in patients with AF.

The effects of Gilbert's syndrome on the mean platelet volume and other hematological parameters

The protective effect of increased levels of indirect bilirubin on atherosclerotic heart disease in patients of Gilbert's syndrome is well known. The aim of the study was to investigate the effects of increased levels of bilirubin on the mean platelet volume (MPV) and other hematological parameters. Thirty-two men and 36 women (a total of 68 Gilbert's syndrome patients) and a similar age group of 68 healthy individuals (32 men and 36 women) were included in the study. Hematologic tests, C-reactive protein (CRP) and biochemical values of the two groups were checked. MPV level of Gilbert's syndrome group was 7.8±1.0fl and CRP 0.2±0.27mg/dl. In the control group MPV was 8.6±1.0fl and CRP 0.3±0.38mg/dl. MPV of patients group (P<0.001) and CRP (P=0.037) were significantly lower than the control group. When dividing Gilbert's syndrome and control groups according to sex into subgroups the level of indirect bilirubin in men with Gilbert's syndrome (1.8±0.8mg/dl) was found to be higher than other groups. Healthy men had higher levels of MPV (8.8±0.9fl) whereas Gilbert's syndrome male patients had lower levels (7.7±1.1fl), (P<0.001). The elevated levels of bilirubin and decreasing levels of MPV and CRP in Gilbert's syndrome patients may have an effect on the slowing down of the atherosclerotic process.

Prognostic value of elevated mean platelet volume in patients undergoing primary angioplasty for ST-elevation myocardial infarction

Objective The aim of this study was to evaluate the prognostic value of mean platelet volume (MPV) in patients with STEMI undergoing primary percutaneous coronary intervention (PCI).Methods We prospectively enrolled 495 consecutive STEMI patients. The study population was divided into tertiles based on admission MPV values. The high MPV group (n = 148) was defi ned as a value in the third tertile (> 8.9), and the low MPV group (n = 347) included those patients with a value in the lower two tertiles (≤ 8.9). Clinical characteristics, in-hospital and six-month outcomes of primary PCI were analysed.Results Higher six-month all-cause mortality rates were observed in the high MPV group In Cox multivariate analysis; a high admission MPV value (> 8.9) was found to be a powerful independent predictor of six-month all-cause mortality.Conclusions These results suggest that a high admission MPV level was associated with increased six-month all-cause mortality in patients with STEMI undergoing primary PCI.

Authors’ Response to: Platelet Indices in Renovascular Thrombosis After a Renal Transplant

We would like to thank Dr. Varol for his recent interest in our article that evaluated mean platelet volume (MPV) before and after renal transplant as a potential predictor of renovascular thrombosis.1 He asked for the methodology of blood sampling to measure MPV in our study. Previously, it was suggested to use tubes with a high concentration of sodium citrate to obtain more reliable measures of MPV.2 However, this recommendation did not meet routine practice demands. Instead, most laboratories, as in our institution, continue to rely on ethylene diaminetetraacetic acid as the standard hematologic anticoagulant by further shortening processing times.3 Mean platelet values have been shown to be independent of the anticoagulation with ethylenediaminetetraacetic acid or citrate if measured within 1 hour of sampling.4 In accord with this recommendation, full blood counts of all the patients at our institution are routinely measured in K3 ethylenediaminetetraacetic acid within 15 minutes of venipuncture. Many factors are known to influence the MPV including smoking, obesity, diabetes mellitus, prediabetes, hypertension, hypercholesterolemia, the metabolic syndrome, some antihypertensive agents, and immunosuppressive drugs. In our study, all patients were children, and none of them smoked. As specified in our original article, obesity was not seen in any of our patients before transplant, and the MPV levels were measured, and found to be decreased by the end of the first month after transplant. In such a short time, no serious weight loss was seen in any patients. None of the patients had a diagnosis of diabetes mellitus or prediabetic status. Hypertension is a prevalent complication occurring in 80% to 85% of all kidney transplant recipients. The pathogenesis of posttransplant hypertension is multifactorial including pretransplant hypertension, donor hypertension, renin secretion from the native kidney, graft dysfunction, recurrent disease, and immunosuppressive treatment.5 Conversely, an abnormally high prevalence of the metabolic syndrome has been seen in patients receiving solid-organ transplants, and some of the pathogenetic factors might include cyclosporine and corticosteroids.6 In our study, no significant differences in blood pressures and serum lipid profiles were seen in any of the patients, either before or after renal transplant. We know that hyperglycemia, hypercholesterolemia, hypertension, and thrombocytopenia are associated with high MPV levels, and such adverse effects of immunosuppressive drugs (cyclosporine or tacrolimus in combination with mycophenolate mofetil and prednisolone) were noted.5-7 There is a paucity of research that investigates the relation between the MPV and use of immunosuppressive agents. In general, increases in the MPV have been reported. Reis and associates compared the effects of sirolimus and cyclosporine, and found that hemoglobin, hematocrit, MPV, and platelet distribution width were significantly higher in the sirolimus group than in the cyclosporine group.8 In another study, Gasparyan and associates9 reported a significant increase in MPV after anti–TNF-alpha therapy in patients with rheumatoid arthritis, but

Mean platelet volume and eosinophilia relationship in patients with bullous pemphigoid

Introduction: Bullous pemphigoid (BP) is an autoimmune skin disease that is characterized by the formation of blisters on normal or erythematous skin. In patients with BP, eosinophils are highly represented in the inflammatory infiltrate of the lesional skin and their levels are often increased in peripheral blood. It is known that eosinophils are the major intravascular source of tissue factor (TF), an initiator of the extrinsic coagulation pathway. Patients with BP are also three times more likely to develop pneumonia and pulmonary embolism than the matched controls. We hypothesized that there might be an association between the eosinophil level and mean platelet volume (MPV) in these patients. Patient and method: A total of 19 patients with BP and age–sex match 22 healthy controls were included in this study retrospectively. MPV before treatment, MPV after treatment, platelet, eosinophil count before treatment, eosinophil count after treatment, white blood cell, glucose, C reactive protein and sedimentation rate were evaluated in BP patients and the control group. Results: The MPV value (8.32 fl ± 1.8) and eosinophil count (1.03 × 103 μL−1 ± 0.36) in patients with BP was significantly higher than that of control subjects (p = 0.036) and (0.22 ×103 μL−1 ± 0.29) (p = 0.002) (p < 0.05, Mann–Whitney U-test). Conclusion: In this study high levels of MPV and eosinophil levels have been detected. MPV may be a useful indicator of the risk of vascular events. Prospective studies are needed to compare disease activity, thromboembolic events and MPV in BP patients.

The relation between mean platelet volume and coronary collateral vessels in patients with acute coronary syndromes

ObjectiveElevated mean platelet volume (MPV) has been proposed as a risk factor for coronary artery disease (CAD) and is associated with poor clinical outcome in acute coronary syndrome (ACS). We aimed to evaluate the association of MPV with presence of coronary collateral vessel (CCV) in patients with ACS. MethodsA total of 417 patients with ACS were included in the study. All patients underwent coronary angiography on the first day after admission and patients with a greater than or equal to 80% obstruction in at least one epicardial coronary artery were included in the study. The CCVs are graded according to the Rentrop scoring system and a Rentrop grade 0 was accepted as no CCV development (Group 1), Rentrop Grade 1–2–3 were accepted as presence of CCV development (Group 2). ResultsThe median of MPV was 9.1±1.4fl. Mean age was 60±12 year. Group 1 consisted of 233 (55.9%) patients and Group 2 consisted of 184 (44.1%) patients. Presence of CCV was significantly associated with high levels of MPV (p=0.005). Presence of CCV was also associated with presence of diabetes and systolic blood pressure. ConclusionHigh MPV on admission was associated with presence of CCV in patients with ACS.

Mean platelet volume as a fibrosis marker in patients with chronic hepatitis C

We designed this study to evaluate the role of mean platelet volume (MPV) as a fibrosis marker in patients with chronic hepatitis C (CHC). Materials and methods: The study was designed at Kayseri Education and Research Hospital. Ninety-five patients with CHC were enrolled retrospectively into the study. The control group comprised 33 age- and sex-matched healthy individuals. Hepatitis C virus-RNA level, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, prothrombin time (PT), platelet count (PC), serum albumin, histological activity index (HAI), liver fibrosis score (LFS), and MPV were obtained from the patients' files and a computerized database. Results: Statistically significant differences in MPV and PC were seen in patients with CHC compared to healthy controls (MPV: 9.1 ± 1.31 fL vs. 8.58 ± 0.8 fL, P = 0.008; PC (×103/µL): 219.37 ± 74.31 vs. 258.52 ± 48.34, P = 0.001). In multivariate analysis, 4 variables remained as independent risk factors: AST (OR 1.11, 95% CI 1.02 to 1.21), ALT (OR 0.92, 95% CI 0.86 to 0.99), PT (OR 2.11, 95% CI 1.15 to 3.88), and MPV (OR 2.28, 95% CI 1.22 to 4.25). Cut-off values were calculated for diagnostic performance, and the cut-off value for MPV was 8.4 fL. Conclusion: We suggest that high MPV levels (especially those over 8.4 fL) may help to predict advanced fibrosis in patients with CHC. However, it should not be forgotten that MPV is not a specific marker for fibrosis, and the negative predictive rate seems more valuable to exclude a high fibrosis ratio in patients with CHC.

Mean platelet volume is elevated in patients with patent foramen ovale

IntroductionPlatelets play a major role in thromboembolic events. Increased mean platelet volume (MPV) indicates higher platelet reactivity and also a tendency to thrombosis. Patent foramen ovale (PFO), persistence of the fetal anatomic shunt between right and left atria, is strongly associated with cryptogenic stroke. The aim of this study is to determine the relationship between MPV and PFO and if such an association exists, whether higher MPV levels may require antiplatelet therapy before a thromboembolic event happens, together with a literature review.Material and methodsThirty patients (15 women, 15 men), free of any cerebrovascular events, were diagnosed with PFO by transesophageal echocardiography (TEE), enrolled as the study group. Thirty consecutive patients (16 women and 14 men), who were diagnosed as normal in TEE, were enrolled as the control group. These two groups were compared according to MPV and anatomical features of the right atrium.ResultsThere was no significant difference between study and control groups in clinical features and also no difference was observed in platelet counts; however, MPV in the PFO group was significantly higher than the control group (8.38 ±0.93 fl and 7.45 ±0.68 fl respectively).ConclusionsOur results indicate that elevated MPV may be detected in patients with PFO. This might be one of the explanations for the relationship between PFO and cryptogenic stroke; however, larger cohorts are warranted in order to define further mechanisms.

Mean platelet volume and D-dimer in patients with suspected deep venous thrombosis

The aim of this retrospective study was to evaluate the diagnostic value of mean platelet volume (MPV) and D-dimer for acute deep venous thromboembolism (DVT). Two hundred and fifty six patients who presented to the emergency or cardiovascular surgery department with suspected lower limb DVT were retrospectively recruited. Plasma levels of MPV, platelet count, and D-dimer were obtained and duplex sonography examination was performed for all patients. Eighty four patients had acute DVT which was diagnosed by duplex ultrasonography. MPV was significantly higher in patients with DVT than in those without DVT (p < 0.01). The mean MPV was 7.97 ± 17.8 and 7.58 ± 0.87 fL in patients with DVT and without DVT, respectively (p < 0.01). D-dimer was significantly higher in patients with DVT (p < 0.01). For all the patients, a positive MPV when the cut-off value was 7.3 fL, had 69.7 % sensitivity and 43.9 % specificity. D-dimer (with a cut-off value of 0.5 μg/mL) had 82.9 % sensitivity and 32.7 % specificity. In case of combination of MPV and D-dimer, the specificity exceeded (65.9 %) despite the reduction in sensitivity (59.2 %). Elevated MPV was found to be associated with acute DVT and high levels of MPV might increase the specificity of D-dimer for exclusion of DVT.

Comparison of mean platelet volume values among different causes of pulmonary hypertension

Pulmonary hypertension is caused by a heterogenous group of disorders with diverse pathophysiological mechanisms, with ultimate structural changes in the pulmonary vascular bed. Platelet activation plays an important role in the development of pulmonary arterial hypertension, while it is unknown whether it contributes to pathogenesis in other conditions. We aimed to investigate platelet activation in different causes of pulmonary hypertension by means of mean platelet volume measurement. A total of 67 patients with different causes of pulmonary hypertension, and 31 controls, were retrospectively reviewed. Patients with pulmonary hypertension were further grouped according to underlying disease, including pulmonary arterial hypertension, pulmonary hypertension due to left ventricular failure, and pulmonary hypertension due to chronic obstructive pulmonary disorder. All patients and controls past medical data, admission echocardiograms and complete blood counts were reviewed. Patients with pulmonary hypertension had higher mean platelet volume levels compared to healthy controls (8.77 ± 1.18 vs 7.89 ± 0.53; p < 0.001), and statistical significance was still present when pulmonary arterial hypertension patients were not included in the pulmonary hypertension group (8.59 ± 1.23 vs 7.89 ± 0.53; p < 0.001). Among patients with pulmonary hypertension, the pulmonary arterial hypertension group and the pulmonary hypertension due to left ventricular failure group had higher mean platelet volumes compared to healthy controls. Mean platelet volume did not correlate with pulmonary artery pressure. Our results indicate that mean platelet volume is not only elevated in pulmonary arterial hypertension, but also due to other causes of pulmonary hypertension.

Relation Between Mean Platelet Volume and Severity of Atherosclerosis in Patients With Acute Coronary Syndromes

Platelets play a central role in the pathophysiology of coronary artery disease (CAD). Increased mean platelet volume (MPV) is an indicator of platelet function and associated with poor clinical outcome in patients with acute coronary syndrome (ACS). We evaluated the relationship between MPV and severity of CAD in patients with ACS. A total of 395 patients with ACS were included. Severity of CAD was assessed with the Gensini and Syntax scores. High levels of MPV were associated with the Gensini and Syntax scores, number of diseased vessels (>50%), number of critical lesions (>50% and >70%), and noncritical lesions. After multivariate analysis, high levels of MPV were independent predictors of multivessel CAD together with age. In patients with ACS, high MPV levels were associated with severity of CAD. It is possible that MPV can be a helpful marker in patients with CAD for the severity of coronary atherosclerosis.

Association of Mean Platelet Volume with Hypertension in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is one of the most common chronic inflammatory disorders associated with enhanced cardiovascular morbidity and mortality. Established high prevalence of classical cardiovascular risk factors may only partly explain cardiovascular phenomenon in this disease. Emerging risk factors, markers of inflammation and prothrombotic state such as platelet size are believed to reflect activity of RA. We aimed to study mean platelet volume (MPV) in a cohort of patients with RA and to clarify possible effects of classical cardiovascular and RA-associated risk factors on MPV. Demographic, clinical and a wide range of laboratory parameters, including MPV and platelet count, were obtained for 400 RA patients. Platelet size and count were also assessed in 360 non-RA controls from the local population. We found significantly increased MPV in RA patients compared with controls (P=0.001). The difference retained significant after adjustment for age and sex. High values of MPV (>or=10.7 femtoliter [fL]) were more frequent in RA patients than in controls (21% vs. 9.2%; P<0.0001). In RA patients, blood pressure greater than 140/90 mmHg was associated with high levels of MPV (Odds Ratio [OR] 2.2, 95% Confidence Interval [CI] 1.3-3.7; P=0.003). It is possible that MPV as a surrogate marker of platelet function reflects enhanced vascular risk. To further explore the role of MPV as a marker for cardiovascular risk in RA, prospective studies are warranted.