Mean Platelet Volume In Group Research Articles

The effect of the mean platelet volume on short-term prognosis in acute ischemic stroke patients who underwent intravenous thrombolytic therapy

Objective: To evaluate the effect of the mean platelet volume (MPV), on the short-term prognosis and bleeding complications of acute ischemic stroke patients who underwent intravenous tissue plasminogen activator (IV-tPA) treatment. Patients and Methods: Between 01.01.2018 and 01.06.2021, 314 ischemic stroke patients who applied to our clinic with acute neurological deficit were included in the study retrospectively. Alteplase was administered as IV-tPA treatment for 1 hour. MPV value was measured before the treatment and was evaluated as the main parameter. The patients were examined under 4 groups (≤8.8fL, >8.8 – ≤9.9, >9.9-≤10.8, >10.8fL) according to their MPV values, and age, gender, comorbidities, and treatment initiation parameters were standardized by statistical methods. It was compared whether there was a significant difference between the MPV groups in terms of short-term prognosis according to the admission National Institutes of Health Stroke Scale (NIHSS) scores and discharge NIHSS scores and also bleeding complications. Results: A total of 314 patients, 145 women with a mean age of 76.7±13.0, and 169 men with a mean age of 66.3±13.1, were included in the study. 31 patients (9.9%) died before discharge. The mean MPV value was 9.64±1.15fL and the mean NIHSS score was 9.1±4.9 at admission, and the mean NIHSS score was 4.3±4.7 at discharge. When the NIHSS difference between admission and discharge was compared in the 4 groups, it was found that the prognosis was better in Group 3 with MPV >9.9-≤10.8 compared to Groups 1 and 4. (p=0.002; p<0.01). Despite this, it was seen that low or high MPV values could not be considered as a prognostic factor alone in patients who received IV-tPA treatment, since, there was no significant difference between the 3rd group and the 2nd group in terms of NIHSS decrease and the 4th group had a worse prognosis than the 3rd group. There was no statistical significance between MPV groups in terms of hemorrhage complications (p value for intracerebral, gastrointestinal, urogenital hemorrhage complications were 0.540, 0.980, 0.783, respectively). Conclusion: In our study, it was revealed that MPV value, is not an independent risk factor in patients with acute ischemic stroke receiving IV-tPA treatment and cannot be used as a prognostic marker.

Correlation of Platelet Parameters With the Severity of Thrombocytopenia in Dengue Fever in Children Aged Less Than 18 Years at a Tertiary Care Centre: A Cross-Sectional Study.

Introduction Dengue is a tropical viral disease caused by dengue virus with varied severity ranging from dengue fever to dengue shock syndrome. In dengue infection, there is thrombocytopenia with platelet activation. According to various proposed theories, activation of platelets during thrombocytopenia leads to changes in platelet parameters like mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), and platelet index (PI). So,this study was conducted to correlate platelet parameters with the severity of thrombocytopenia in children with dengue fever at a tertiary care hospital. Methods An observational cross-sectional study was conducted on 72 children below 18 years admitted with dengue infection at a tertiary care hospital. All 72 patients were divided into three groups depending on platelet count. Group I included individuals with a platelet count less than 50000/mm3, while group II comprised patients with platelet counts ranging between 50001/mm3 and 100000/mm3, and group III encompassed individuals with platelet counts exceeding 100001/mm3. Platelet parameters like MPV, PDW, PCT, and PI were analyzed on day one and day three of admission. These parameters on day one and day three were correlated with the severity of thrombocytopenia in all three groups. Results PCT values on day one and day three were statistically significant (p<0.05) in all three groups with p-value <0.001 withprofound positive correlation, which means PCT value decreases with increasing severity of thrombocytopenia. PI in group I was statistically significant on day one (p=0.009) but not on day three (p=0.063). PI in group II was statistically significant(p<0.05) on day three (p=0.002), while in group III, PI was significant statistically on day one (p<0.001). MPV in group I, on day one(p=0.006) and in group II, on day three(p= 0.049) were statistically significant(p<0.05).PDW was statistically significant only on day one (p=0.031) in group I, while was not significant in groups II and III. Conclusion MPV, PDW, and PCT increasewith a decrease in platelet count, whereas there isan increase in PI. These platelet indices could be used to predict the severity of thrombocytopenia and severity of the dengue fever. Along with MPV and PDW, PCT could be used to assess the severity of the disease progression.

Correlation between Mean Platelet Volume and Gensini Score in Patients with Coronary Heart Disease in Different Diabetic States.

To investigate the correlation between mean platelet volume (MPV) levels and Gensini scores in stable coronary heart disease (CHD) patients with or without diabetes. A retrospective analysis was conducted on 2525 patients with stable CHD in Zhongshan Hospital, Fudan University. There were 1274 in the low MPV group and 1251 in the high MPV group, divided by a median MPV level of 10.9 fL. In the total population, 1605 patients were non-diabetic and 920 were diabetic. The severity of coronary artery disease was quantified using the Gensini score. The Gensini score was significantly higher in the high MPV group than in the low MPV group (p < 0.001). MPV levels increased significantly with the number of stenotic (>50%) coronary vessels (p < 0.001). The Spearman analysis showed a positive correlation between MPV and Gensini score (r = 0.189, p < 0.001), which was more significant in the diabetic subgroup (r = 0.232, p < 0.001). Receiver operating characteristic (ROC) curves were employed to assess the predictive value of MPV for high Gensini scores, using the median value of 32 points as the cutoff. MPV levels in the diabetes cohort exhibited a higher predictive value for high Gensini scores (area under the curve: 0.635 [0.614-0.657], p < 0.001). Multivariate linear regression analysis showed that diabetes and MPV were independently associated with Gensini scores. MPV levels in stable CHD patients can predict the severity of coronary artery stenosis. This correlation is more significant in the presence of diabetes.

TO KNOW THE ASSOCIATION OF PLATELET ACTIVITY ON GLYCEMIC STATUS AND VASCULAR COMPLICATIONS IN DIABETES MELLITUS

Background: Diabetes mellitus is a global pandemic disease. Hyperglycemia contributes to greater platelet reactivity through direct effects and by promoting glycation of proteins. Mean platelet volume(MPV) and Mean platelet count(MPC) is an indicator of average size and activity of the platelets and is high in diabetes mellitus. Objectives: 1) To nd the association between MPC and MPVwith HBA1C in diabetic patients. 2) To nd the association of MPC and MPV with vascular complications in diabetic patients. Methodology: A retrospective study conducted in the Department of Pathology from January 2021 to June 2021. Data was collected from backbone stored in digital form. Sample size : 92 diabetic patients and are divided into 2 groups. 1) Group 1: HbA1c &lt;7. 2) Group 2: HbA1C ≥7. Platelet count, MPV, HbA1c values and vascular complications were analyzed. Results: Out of 92 diabetic patients 74 had vascular complications. MPC in group 1 and group 2 was found to be 231.727 and 312.346 respectively with signicant p value of 0.036 and mean difference of -80.6184. MPV in group 1 and group 2 was found to be 10.200 and 9.999 respectively which showed no signicant correlation with p value of 0.528 and mean difference of 0.2012. The MPC and MPV in diabetic patients with complications were 332.056 and 10.239 respectively showing no signicant correlation. Conclusion: MPC and MPV were found to be raised in group 2. MPC between the 2 groups showed statiscally signicant difference. However MPV does not show any signicance between the two groups. Though there was no signicant difference between Platelet count and vascular complication, MPVwas higher in patients with complications. Diabetic patients suffer mostly from vascular complications, therefore platelet count and HbA1c can be a useful prognostic marker of vascular complications in diabetics.

Complex effects of whole body cryostimulation on hematological markers in patients with obesity.

BackgroundAdaptation, including changes in blood properties, to whole-body cryostimulation may depend on many factors, including body mass.AimThis study investigates whether hematological parameters change similarly in a group of people with obesity and a group of men with normal body weight after 10 and 20 cryostimulation treatments.MethodsIn our non-randomized trial, the participants were divided into two groups based on their body fat percentage: 14 men with a high (HBF = 29.35%) and 10 with a normal percent of body fat (NBF = 11.40%) and subjected to 20 whole body cryostimulation treatments (-120°C for 2–3 minutes). Blood samples were taken before the first and after the 10th and 20th cryostimulation. The following parameters were determined: red blood cells (RBC), hemoglobin concentration (HGB), hematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), platelets (PLT), red blood cell distribution width (RDW-SD), mean platelet volume (MPV), white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), monocytes (MONO), eosinophils (EO) and basophiles (BASO).ResultsStatistically significant differences were found in red blood cells parameters such as RBC, HCT, MCV and MCHC. Time influence was noted for HCT, MCV and MCHC. Two-way ANOVA showed a significant correlation (for time and group) for 2 paramateres: RBC and MCV. For platelet parameters statistically significant differences were found for PLT (group influence) and MPV (time and group interaction). In white blood cells parameters statistically significant differences in levels of LYMPH were noted. Higher levels were observed for HBF group.ConclusionsAll observed changes were within the reference range, but hematological markers changed unevenly in people who are obese and non-obese. Therefore, it appears that an amount of fat tissue could be a factor causing the differences in adaptation to low temperature. It is suggested that 20 whole body cryostimulation sessions restore the state of homeostasis disturbed after 10 sessions.Trial registrationACTRN 12619000524190.

Platelet volume indices correlate to severity of heart failure and have prognostic value for both cardiac and thrombotic events in patients with congenital heart disease

Abstract Introduction Patients with heart failure are reported to have activated platelets leading to thrombotic events. Consequently, immature giant platelets are produced, and platelet distribution width (PDW) and mean platelet volume (MPV) increase. These platelet indices are easily, reasonably, and safely available by routine blood test and recently have been proposed as potential markers of cardiac events. However, little is known about the usefulness of platelet indices in patients with congenital heart disease (CHD). Purpose To test whether the hypothesis that PDW and MPV correlate to the severity of heart failure and have prognostic value in both future heart failure-related admission and thrombosis formation in patients with CHD. Methods We performed a retrospective, single-centre study that included 400 patients with CHD (median age, 34 years [range: 12–76]; 49% males; 35% single ventricular morphology), who were admitted in our institute between April 2014 and June 2017. We reviewed patients' medical records to assess their clinical information including medical history, blood sample data, and echocardiologic parameters. At first, we assessed the correlation between platelet indices and patients' clinical parameters. Next, we compared platelet indices before and after treatment for heart failure. Finally, using logistic regression and Kaplan-Meier analyses, we assessed prognostic factors of future heart failure-related admission and thrombosis formation. Results In multivariate analysis, a significant correlation was found between PDW and logBNP (brain natriuretic peptide) (p&amp;lt;0.001), haemoglobin (p=0.01), D-dimer (p=0.019), Fontan operation (p&amp;lt;0.001) and male sex (p&amp;lt;0.001); as well as between MPV and logBNP (p&amp;lt;0.001), D-dimer (p&amp;lt;0.001) and Fontan operation (p=0.002). Throughout treatment of heart failure, significant reduction was found both in PDW (average value before treatment = 14.2, after treatment = 13.2, p=0.002) and MPV (before = 11.2, after = 10.8, p=0.004). In multivariate logistic regression analysis, predictors of future heart failure-related admissions were PDW (hazard ratio [HR]: 1.365; 95% confidence interval [CI]: 1.005–1.768), MPV (HR: 1.472; 95% CI: 1.055–2.052), age (HR: 1.063; 95% CI: 1.010–1.119), and SpO2 under 85% (HR: 5.089; 95% CI: 1.350–19.18). Using the same analysis, predictors of thrombotic formation were PDW (HR: 1.998; 95% CI: 1.461–2.630), MPV (HR: 1.792; 95% CI: 1.155–2.781), logBNP (HR: 1.196, 95% CI: 1.085–1.320), D-dimer (HR: 1.024; 95% CI: 1.007–1.042) and male sex (HR: 3.071; 95% CI: 1.079–8.737). In addition, during median follow-up of 28 months, the Kaplan-Meier analysis showed an improvement in both heart failure and thrombosis-free survival in the low PDW, as well as the low MPV group. Conclusion Platelet volume indices correlate to severity of heart failure and have prognostic value for both cardiac and thrombotic events in patients with congenital heart disease. Funding Acknowledgement Type of funding source: None

Association of Mean Platelet volume With Angiographic Thrombus Burden In Patient With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutanous Coronary Intervention

Background: ST-elevation myocardial infarction (STEMI) is one of the leading causes of mortality and morbidity worldwide. However, survival after acute STEMI has considerably improved due to increasing symptom recognition, accurate diagnosis and effective timely reperfusion. Objectives: To assess the association of mean platelet volume (MPV) as a biomarker for angiographic thrombus burden in patient with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention (PPCI). Patients and methods: This study was conducted on 125 patients admitted to El-Mokatem health insurance hospital, with the diagnosis of acute ST-segment elevation myocardial infarction (STEMI) treated with PPCI in the period between December 2018 and October 2019. Results: Thrombus burden level determined by TIMI thrombus grade (TIMITG) was significantly higher in the high MPV group (p-value 9.75 predicted LTB with 83.3% sensitivity and 86.2% specificity. Multivariate logistic regression analysis demonstrated MPV was an independent predictor of large intracoronary thrombus burden in patients with STEMI undergoing PPCI Conclusion: In STEMI patients who underwent PPCI, MPV on admission was significantly higher in those who experienced high thrombus burden. MPV on admission may serve as a readily available an independent predictor of the thrombus burden in STEMI patients undergoing PPCI. Keywords: Mean Platelet volume, TIMITG, HTB, PCI, PPCI, STEMI

Higher mean platelet volume is accompanied with hyperthyroidism in patients with Graves’ disease

Purpose: Graves’ disease (GD) is an autoimmune disease that is the most common cause of thyrotoxicosis. Thyrotoxicosis can cause a decrease in platelet survival time. Inflammation is an important stimulus for platelets and mean platelet volume (MPV) could be used a diagnostic marker which is an important determinant of platelet activity. In this study we aimed to evaluate whether MPV would be a useful inflammatory marker for evaluation of disease activity in patients with Graves’ disease.Materials and Methods: Two hundred twenty-nine patients (GD patients (Group 1); n=102 and patients with euthyroid nodular goiter (Group 2); n= 127) were included in this retrospective study. Serum TSH, fT3, fT4 and MPV levels were recorded at presentation and at first euthyroid period under ATD treatment in GD patients and at presentation in patients with euthyroid nodular goiter.Results: The mean age was 40.3±13.5 in Group 1 and 50.2±11.6 in Group 2. Mean initial MPV level did not differ between groups; 8.3±1.2 fL and 8.3±1.1 fL, respectively (p=0.9). We found that mean initial MPV was higher than the first euthyroid period MPV in Group 1; Graves’ group (8.3±1.2 fL vs 8.0±1.3 fL, p= 0.02). Conclusion: Higher initial MPV levels in Graves patients and significant drop following the restoration of hyperthyroidism may be due to hypermetabolism of hyperthyroidism.

Long-term prognostic value of mean platelet volume in patients with stable coronary artery disease undergoing elective percutaneous coronary intervention

Objective: To evaluate the relationship between admission mean platelet volume (MPV) and 2-year cardiac mortality in patients with stable coronary artery disease (CAD) undergoing elective percutaneous coronary intervention (PCI), and explored the consistence of this relationship in diabetes mellitus (DM) and non-DM subgroups. Method: A total of 4 293 patients who underwent PCI in Fuwai Hospital in 2013 were enrolled and divided into two groups according to MPV as follows: lower MPV (n=2 219, MPV≤10.5fL) and higher MPV (n=2 074, MPV>10.5fL). Result: Patients with high MPV had a higher rate of DM (30.4%(674/2 219) vs 34.5%(715/2 074)), smoking (53.3%(1 183/2219) vs 57.0%(1 182/2 074)), and previous coronary artery bypass grafting (CABG) (4.0%(88/2 219) vs 5.4%(112/2 074)), while left ventricular ejection fraction (LVEF) (64±7 vs 63±7), and glomerular filtration rate (eGFR) (92±14 vs 91±15) were lower compared with patients in the low MPV group (all P<0.05). In the laboratory examination, patients with high MPV had higher glycosylated hemoglobin, and lower platelet count (all P<0.05). In coronary angiography, there was no significant difference in SYNTAX scores, left main/three-vessel lesions, stent type, success rate of operation, and total stent length (all P>0.05). Compared with low MPV group, patients with high MPV had ahigher cardiac mortality [18 (0.9%) vs 5 (0.2%), P=0.004]. Kaplan-Meier analysis showed that compared to low MPV group, cardiac mortality in high MPV group was significantly higher (Log-rank P=0.004). Multivariate Cox regression analysis showed that high MPV was independently associated with 2-year cardiac mortality (HR 4.127, 95%CI 1.373 to 12.405, P=0.012). Receiver operating characteristic curve (ROC) analysis also showed that MPV had a good diagnostic value in predicting 2-year cardiac mortality (area under the curve=0.624, 95%CI: 0.511-0.738, P=0.04). Subgroup analysis showed that in patients with DM (HR 2.090, 95%CI 1.217-3.589, P=0.008) and male (HR 1.561, 95%CI 1.007-2.421, P=0.047), MPV was significantly related with cardiac mortality. Conclusion: In patients with stable CAD who underwent elective PCI, high MPV was independently associated with an increase in 2-year cardiac mortality, especially in patients with DM and male gender.

Impact of Platelet Volume on the Clinical Outcomes of Patients with Acute Coronary Syndrome.

Platelets with high hemostatic activity play an important role in the pathophysiology of acute coronary syndrome (ACS), and mean platelet volume (MPV) has been proposed to be an indicator of platelet reactivity. We evaluated the predictive value of MPV and the responsive value of MPV with different antiplatelet agents in association with the clinical outcomes of ACS patients. A total of 1094 patients with ACS and 472 patients without ACS were included. Blood samples were taken at hospital admission, at routine follow-up within one year, and beyond one year. The patients were divided into a "high MPV group" (> 9.0 fl, n = 305), "medium MPV group" (7.9-9.0 fl, n = 517), and "low MPV group" (< 7.9 fl, n = 272). The average follow-up time was 2.4 years, and the endpoints were major adverse cardiovascular events (MACEs) including all-cause mortality, time to recurrent ACS, target vessel re-intervention and stroke. MPV was significantly higher in the patients with ACS than in those without ACS (8.6 ± 1.1 vs. 8.4 ± 1.0 fl, p = 0.007). MPV decreased in the following year (8.38 ± 1.02 fl, p < 0.001) and also beyond one year (8.38 ± 0.94 fl, p < 0.001) after ACS events. The changes in MPV were not significantly different between the patients receiving either clopidogrel or ticagrelor. The high MPV group had more cardiovascular risk factors and more MACEs than the low MPV group (p = 0.017). A higher MPV in patients with ACS was associated with more cardiovascular risk factors and more cardiovascular events during clinical follow-up.

Lower mean platelet volume is a risk indicator of hepatocellular carcinoma recurrence following liver transplantation

BackgroundLower mean platelet volume (MPV) is an indicator of platelet activity in the setting of tumor development. This study was to assess the relationship between preoperative MPV and survival outcomes of patients with hepatocellular carcinoma (HCC) following liver transplantation (LT). MethodsThe demographic and clinical characteristics of 304 HCC patients following LT were retrieved from an LT database. All the patients were divided into the normal and lower MPV groups according to the median MPV. The factors were first analyzed using a Kaplan–Meier survival analysis, then the factors with P < 0.10 were selected for multivariate Cox regression analysis and were used to define the independent risk factors for poor prognosis. ResultsThe 1-, 3-, and 5-year tumor free survival was 95.34%, 74.67% and 69.29% in the normal MPV group, respectively, and 95.40%, 59.97% and 42.94% in the lower MPV group, respectively (P < 0.01). No significant difference was observed in post-LT complications between the normal and lower MPV groups. Portal vein tumor thrombosis (PVTT) [hazard ratio (HR = 2.24; 95% confidence interval: 1.46–3.43; P < 0.01) and lower MPV (HR = 1.58; 95% confidence interval: 1.05–2.36; P = 0.03) were identified as independent prognostic risk factors for recipient survival. ConclusionPreoperative lower MPV is a risk indicator of HCC patients survival outcomes after LT.

Use of mean platelet volume as a tool to assess the progression of type 2 diabetes mellitus

Background: Diabetes mellitus (DM) is characterized by chronic hyperglycemia resulting in micro- and macro-vascular complications and is correlated with glycemic control and its duration. The undergoing pathologic thrombosis associated with atherosclerotic plaque rupture is a major cause of morbidity and mortality. Mean platelet volume (MPV) is a simple economical test in the monitoring of DM. Aims and Objectives: This study aims to determine the activation of platelets in diabetes by measuring the MPV in non-diabetic and diabetic subjects, respectively and to find out the correlation of MPV with blood glucose level. Materials and Methods: It was a cross-sectional study conducted on 70 previously diagnosed diabetic and 130 non-diabetic patients using convenient sampling in SCB Medical College, Odisha. Blood parameters such as body mass index (BMI), fasting blood sugar (FBS), postprandial blood sugar (PPBS), glycated hemoglobin (HbA1c), and MPV were recorded from complete blood count and compared using independent sample t-test and Pearson correlation test. Results: Mean age of the diabetic population was 53.7 ± 10.63 years. Positive correlation was found between MPV and BMI, FBS, PPBS, and HbA1c. The mean MPV in Group A was significantly lower than that of Group B. Conclusion: MPV in Type 2 DM was significantly elevated and positively correlated to blood glucose level. Thus, strict glycemic control measures should be advised to patients with DM for halting the progression of complications in them.

Relationship between mean platelet volume and metabolic syndrome in Chinese patients

Mean platelet volume (MPV) is a determinant of activation and variability of platelets (PLT). The focus of this study was to to investigate MPV values in patients with and without metabolic syndrome (MS). It also evaluates the association between them. There are close connections among MPV, MS, and cardiometabolic risk. We compiled age, body mass index, blood cell counts, MPV, and other data of 59976 self-reported healthy volunteers (28428 male, 31548 female), 24.65% of who have MS. The mean age of the group was 48.21 years old. The data was grouped by sex and values of data between men and women groups were analyzed by independent sample’s t-test. The relationship between sex and MS was evaluated by chi-square tests. Crude odd ratios of MS between MPV quartiles and 95% confidence intervals were analyzed by binary logistic regression in this study. We found women had higher levels of MPV (10.09 vs. 9.98, P < 0.01) and PLT (228.68 vs. 212.11, P < 0.01) than men. In females, the prevalence of MS was higher in low MPV group than in high MPV groups. The odds of having MS were significantly lower in higher MPV quartiles compared with MPV Quartile 1 in women (Adjusted OR < 1, P < 0.01). This study indicated that MS was inversely associated with MPV in females only.

Mean platelet volume and long-term cardiovascular outcomes in patients with stable coronary artery disease

Background and aimsAlthough an elevated mean platelet volume (MPV) has been associated with poor clinical outcomes after acute coronary syndrome (ACS), the association between MPV and long-term outcomes in patients with stable coronary artery disease (CAD) remains uncertain. We aimed to investigate the impact of pre-procedural MPV levels in patients following elective percutaneous coronary intervention (PCI). MethodsWe studied 2872 stable CAD patients who underwent their first PCI and who had available data on pre-procedural MPV between 2002 and 2016. Patients were divided into quartiles based on their MPV. The incidences of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, were evaluated. ResultsThe median MPV was 10.4 fL (interquartile range: 9.8–11.0). During a median follow-up of 5.6 years, 498 (17.3%) MACE were identified, with a cumulative incidence significantly higher in the lowest MPV group than in other groups (p < 0.01). After adjustment for platelet count and the other cardiovascular risk factors, the lowest MPV group had a significantly higher risk of MACE compared with the highest MPV groups (hazard ratio: 1.43, 95% confidence interval 1.10–1.86, p = 0.009). Decreasing MPV as a continuous variable was associated with the incidence of MACE (hazard ratio: 1.16 per 1 fL decrease, 95% confidence interval 1.04–1.30, p = 0.007). ConclusionsContrary to previous studies on ACS patients, this study showed that a low MPV was associated with worse clinical outcomes among stable CAD patients.

Correlation between platelet related parameters and acute rejection in renal transplant recipients

Objective To investigate the relationship between primary platelet parameters and early acute rejection (AR) after renal transplantation. Methods From October 2015 to June 2017, 112 patients with renal failure underwent allograft renal transplantation in the Second People's Hospital of Shanxi Province were selected as the research objects, according to the preoperative and postoperative 30d in platelet parameters based on the occurrence of AR they were classified into the observation group (23 cases), no rejection for the control group (89 cases). analysis the difference of two groups of patients with platelet parameters [peripheral blood platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV) and platelet volume distribution width (PDW), the ratio of large platelet (P-LCR)] at preoperative (T0), postoperative 5 d (T1), 10 d (T2) after operation, postoperative 15 d (T3) 15, 30 d (T4). The correlation between PLT, PCT, MPV, PDW, P-LCR and acute rejection after renal transplantation was also analyzed. Results Compared with those of preoperative, the PLT[(122.06±49.67)×109/L vs.(185.26±63.49)×109/L)], PCT[(0.46±0.28)% vs.(0.34±0.06)%)] in T1, T2 of the two group after surgery declined (P<0.05). MPV, PDW and P-LCR were increased in both groups after surgery (P<0.05), and the observation group were higher than that in the control group MPV[(13.69±0.59) vs.(12.24±0.42), (16.08±0.61) vs.(12.52±0.57)], PDW[(13.26±1.19) vs.(12.13±2.14), (15.46±3.15) vs.(12.72±2.09)], P-LCR[(30.57±7.29) vs.(28.13±6.34), (33.01±3.98) vs.(29.13±6.91)] at the baseline of T1 and T2 (all P<0.05). Correlation analysis showed that the level of MPV , PDW , P-LCR and the occurrence of acute rejection after kidney transplantation were positively correlated (r=0.464, 0.606, 0.512, all P<0.05), while the PLT, PCT has nothing to do with the occurrence of acute rejection after kidney transplantation. Conclusion MPV, PDW and P-LCR can indirectly reflect the occurrence of AR after renal transplantation, and the trend of monitoring the three indexes of MPV, PDW and P-LCR after operation is an auxiliary diagnostic method for postoperative AR. Key words: Kidney transplantation; Kidney failure, chronic; Blood platelets; Graft rejection

Combination of Mean Platelet Volume and Neutrophil to Lymphocyte Ratio Predicts Long-Term Major Adverse Cardiovascular Events After Percutaneous Coronary Intervention.

We hypothesized that the combination of a high neutrophil to lymphocyte ratio (NLR) and mean platelet volume (MPV) would be a stronger predictor of future cardiovascular events after percutaneous coronary intervention (PCI). Both NLR and MPV were measured in 364 consecutive patients undergoing PCI. The primary end point was the incidence of major adverse cardiovascular events (MACEs), including cardiac death, nonfatal myocardial infarction, and stent thrombosis. The median values of NLR and MPV were 2.8 and 8.2 fL, respectively. There were 26 MACEs during a median follow-up duration of 29.3 months. Kaplan-Meier analysis revealed that the higher NLR group had a significantly higher MACE rate than the lower NLR group and that the higher MPV group had a significantly higher MACE rate than the lower MPV group (log-rank: P = .0064 and P = .0004, respectively). The cumulative MACE-free survival can be further stratified by the combination of NLR and MPV. This value was especially useful in patients with acute coronary syndrome (ACS). By multivariate Cox proportional hazards model, the combination of high NLR and high MPV was independently associated with MACE ( P = .026). The combination of a high NLR and high MPV is an independent predictor of MACE after PCI, especially in patients with ACS.

Clinical Significance of Mean Platelet Volume Determination in Multiple Myeloma

To investigate the clinical significance of mean platelet volume(MPV) in patients with multiple myeloma(MM). The clinical data of 198 patients with MM admitted in our hospital from March 2008 to March 2015 were collected and analyzed. The clinical data included the Ig type, hemoglobin level, platelet count, creatinine, calciumion albumin, β2-MG, LDH, plasmocytes in bone marrow, MPV, complications such as diabetes, a history of venous thromboembolism (VTE) and arterial events such as coronary artery disease, cerebrovascular disease, thrombosis and blood clotting. All patients were divided into low MPV group (≤8.50 fl) and high MPV group (>8.50 fl). The biochemical parameters and prognosis of the 2 groups were compared. When MPV was 8.50 fl, the higest sensitivety and specificity were 55.56% and 80.00% respectively. The area under curve (AUC) was 0.656 (95% CI: 0.515-0.797), the IgA type, creatinine level and IgH rearrangement in MM patients were related with MPV. The ratio of IgA and IgH rearrangements in patients with low MPV was higher than that in patients with high MPV, and the ratio of patients with creatinine >176.8 µmol/L was lower than that of patients with high MPV (P<0.05). The age, sex, ECOG PS, complications, ISS stage, hemoglobin level, platelet count, calcium ion, albumin, β2 microglobulin, lactate dehydrogenase and bone marrow plasma cell ratio were not statistically significantly different between the 2 groups. Patients with low MPV had a shorter OS (P=0.039) than those with higher MPV. Univariate analysis showed that MPV, BM plasma cell ratio and age>60 years correleted with OS. Multivariate analysis showed that the low MPV and BM plasma cell ratio were correlated with shorter OS (P<0.05). The low MPV is correlated with poor prognosis in patients with MM and may serve as an important indicator for disease progression and prognosis of patients with MM.

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.

Abstract 12102: Use of Mean Platelet Volume to Predict Significant Coronary Artery Disease in Patients With Non-ST Elevation Acute Coronary Syndromes

Background: Acute coronary syndrome (ACS) is characterized by unstable plaque and thrombotic process involving central role of platelets (PLT). Significant number of patients undergoing cardiac catheterization with non-STE ACS have non-significant coronary artery disease (CAD). It is postulated that an increase in Mean platelet volume (MPV) signifies an increase in inflammation during ACS, and thus, a higher risk of significant CAD. Method: This retrospective study enrolled patients with non-STE ACS who underwent coronary angiography from two teaching hospitals from 2011 to 2016. Significant CAD was defined &gt;70% stenosis in at least one coronary artery. Exclusion criteria included patients with known CAD, hematologic disease, and on anticoagulant medication. Hematologic and angiographic data were collected by independent observers. Results: A total of 213 patients were enrolled (male 53%, mean age 61± 12.3). Mean MPV level was 8.9 fl and 45% of patients had significant CAD. When comparing patients with high MPV (MPV&gt;=9 fl) vs low MPV (MPV&lt;9 fl), high MPV group had significantly more significant CAD (55% vs 35% p =0.005) and higher HbA1c (6.9 vs 6.4 p =0.02). Both groups had similar DM, HTN, smoking, and obesity rates. Patients with significant CAD had high MPV level (9.2± 1.07 fl vs 8.6 ± 1.03 fl p =0.001), high MPV/PLT (0.46 vs 0.40 p =0.01), older age (64.5±11 vs 59.2 ± 12 p =0.02), low HDL level (42±12 vs 47 ±16 p =0.01), and non-significantly low PLT count (219 vs 230 p =0.2). Multivariate analysis showed that increased age (AOR 1.04 95% CI 1.01-1.07, p =0.002), high MPV (AOR 1.46, 95% CI 1.01-1.076, p =0.01), high troponin (AOR 3.01, 95% CI 1.40-6.46, p =0.005), and low HDL levels (AOR 0.96, 95% CI 0.94-0.99, p =0.005) were associated with significant CAD. High MPV along with high troponin level was associated with a 4.8-fold increased risk for significant CAD as compared with normal MPV with high troponin (OR 4.8, 95% CI 1.31-17.6, p =0.001). Conclusion: Non-STE ACS patients with high MPV had significantly more significant CAD. Adding high MPV level to troponin level increased the predictive value of significant CAD. This result may help determine who would benefit from cardiac catheterization. This finding needs to be further validated in larger, prospective studies.

High-sensitivity C-reactive protein and mean platelet volume as predictive values after percutaneous coronary intervention for long-term clinical outcomes: a comparable and additive study.

This study was designed to establish the relationship of high-sensitivity C-reactive protein (hsCRP) and mean platelet volume (MPV) with the development of adverse outcomes after percutaneous coronary intervention (PCI). hsCRP levels and MPV were analysed in 372 patients who underwent PCI, with the primary endpoint as major adverse cardiac and cerebrovascular events (MACCE): a composite of cardiac death, myocardial infarction (MI), target vessel revascularization (TVR), ischemic stroke and stent thrombosis. During the follow-up period (mean, 25.8 months), there were 21 cardiac deaths, 10 MIs including four stent thrombosis events, seven ischemic strokes and 29 TVRs. The hsCRP cut-off level was set at 0.31 mg/dl using the receiver operating characteristic curve to differentiate between the groups with and without MACCE. The MPV cut-off level was set at 8.00 fl by the receiver operating characteristic curve to differentiate between the groups with and without MACCE. A Kaplan-Meier analysis revealed that the high hsCRP group (≥0.31 mg/dl) had a significantly higher cardiac death and MACCE rate than the low hsCRP group (<0.31 mg/dl), and the high MPV group (>8.00 fl) had a significantly higher cardiac death and MACCE rate than the low MPV group (≤8.00 fl). Furthermore, the high hsCRP and MPV groups were significantly associated with an increased risk of MACCE. These results show that hsCRP and MPV are predictive markers after PCI for MACCE; they are also additively associated with a higher risk of MACCE.