Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta‐analysis

Abstract

Summary Aim To determine whether an association exists between mean platelet volume (MPV) and acute myocardial infarction (AMI) and other cardiovascular events. Platelet activity is a major culprit in atherothrombotic events. MPV, which is widely available in clinical practice, is a potentially useful biomarker of platelet activity in the setting of cardiovascular disease. Methods and Results We performed a systematic review and meta-analysis investigating the association between MPV and AMI, all-cause mortality following myocardial infarction, and restenosis following coronary angioplasty. Results were pooled using random-effects modeling. Pooled results from 16 cross-sectional studies involving 2809 patients investigating the association of MPV and AMI indicated that MPV was significantly higher in those with AMI than those without AMI [mean difference 0.92 fL, 95% confidence interval (CI) 0.67–1.16, P < 0.001). In subgroup analyses, significant differences in MPV existed between subjects with AMI, subjects with stable coronary disease (P < 0.001), and stable controls (P < 0.001), but not vs. those with unstable angina (P = 0.24). Pooled results from three cohort studies involving 3184 patients evaluating the risk of death following AMI demonstrated that an elevated MPV increased the odds of death as compared with a normal MPV (11.5% vs. 7.1%, odds ratio 1.65, 95% CI 1.12–2.52, P = 0.012). Pooled results from five cohort studies involving 430 patients who underwent coronary angioplasty revealed that MPV was significantly higher in patients who developed restenosis than in those who did not develop restenosis (mean difference 0.98 fL, 95% CI 0.74–1.21, P < 0.001). Conclusions Elevated MPV is associated with AMI, mortality following myocardial infarction, and restenosis following coronary angioplasty. These data suggest that MPV is a potentially useful prognostic biomarker in patients with cardiovascular disease. Whether the relationship is causal, and whether MPV should influence practice or guide therapy, remains unknown.

The association between mean platelet volume levels and poststroke depression

“…The regulation of the platelet activity might explain the association between MPV and depression. As a routinely available measure of platelet size at admission, MPV can be considered as a biological indicator of platelet activity (Chu, et al, 2010), which was correlated with depression (Musselman, et al, 1996; Shimbo et al, 2002). This accorded well with one study based on a large population, which reported that elevated MPV levels were associated with major depression (Canan, et al, 2012).…”

“…As a marker of platelet function, Mean platelet volume (MPV) involves in platelet reactivity, including aggregation and release of platelet factor 4, thromboxane A2, as well as β‐thromboglobulin (Sharp et al, 1995). As a meta‐analysis comprising 24 trials demonstrated, MPV is a positively associated with incidence of myocardial infarction as well as restenosis after coronary angioplasty (Chu et al, 2010). Meanwhile, high MPV levels had been found in patients with aortic arterial stiffness, peripheral artery disease (Balta et al, 2014; Berger, Eraso, Xie, Sha, & Mohler, 2010).…”

Association between mean platelet volume and hypertension incidence

“…2 In past decades, the association between elevated MPV and increased cardiovascular events has been demonstrated by a number of studies. 3 Hypertension affects more than one-quarter of Chinese individuals and is the one of the leading causes of stroke and death. 4 The incidence of hypertension has dramatically risen in recent years, especially in the middle-aged and elderly populations, posing an enormous economic and medical care burden on both society and the national medical insurance system.…”

Mean Platelet Volume in Children with Familial Mediterranean Fever and the Relationship with Attack Status, Colchicine Treatment and Gene Mutation

“…Because large platelets are more active hemostatically (12)(13)(14), higher MPV levels in FMF can be associated with increased risk of atherosclerosis. Additionally, a few previous studies have shown that FMF was associated with increased atherosclerosis risk (17)(18)(19).…”

“…High-grade inflammatory diseases, such as rheumatoid arthritis and psoriasis present with high levels of MPV, which reverse in the course of anti-inflammatory therapy (10,11). Increased MPV is a manifestation of platelet functions and activation, and accepted as a prognostic biomarker in patients with cardiovascular disease (12)(13)(14). Chronic systemic inflammation may, at least in part, contribute to formation and progression of atherosclerotic plaque and cardiovascular involvement (15,16).…”