Mean Platelet Volume as a Marker of Vasculogenic Erectile Dysfunction and Future Cardiovascular Risk

Abstract

Cardiovascular diseases are the main cause of mortality in the Western population, so the attempt to find a marker capable of predicting their early onset is not surprising. It is known that arteriogenic erectile dysfunction (ED) precedes the onset of a major coronary event by several years. However, a marker that is able to early identify those patients who should undergo further diagnostic investigations is, to date, missing. Recent research on this topic has focused on the role of the mean platelet volume (MPV), a marker of platelet activity that is high in most vascular diseases, such as coronary artery disease (CAD), stroke, peripheral artery disease (PAD), and ED. The basic pathophysiological mechanism of all these clinical conditions is atherosclerosis. Platelets play a central role in amplifying this process both indirectly by stimulating endothelial cells to produce inflammatory cytokines and chemokines, and directly through the expression of membrane receptors and the release of molecules that contribute to the formation of atherosclerotic plaque. The objective of this review is to critically analyze the evidence on the role of MPV in predicting the diagnosis and severity of vasculogenic ED and the possibility of using this simple marker as a first step to start a diagnostic process aimed at assessing the cardiovascular risk in these patients.

Neutrophil to Lymphocyte Ratio (NLR) as an Easily Accessible Parameter for Monitoring Tacrolimus Overdose after Heart Transplantation—Experimental Study

“…The MPV prognostic value in chronic lymphocytic leukemia was shown by Masternak et al [ 27 ]. Cardiovascular risk prognosis related to MPV values was postulated by Crafa et al [ 28 ]. Hepatocellular carcinoma recurrence after liver transplantation predicted by MPV was proven by Zhang et al [ 29 ].…”

The penile duplex ultrasound: How and when to perform it?

“…Since the MPV is an index of platelet activity, it correlates with the presence of more thrombogenic platelets and accordingly with vascular pathologies including ED. 45 Indeed, the increase in mean platelet volume correlates with an approximately 2.28-fold increase in the risk of developing CAD, with an increase in mortality following CAD and with a greater risk of restenosis after angioplasty. It has similarly been correlated with an increased risk of stroke and peripheral arterial disease.…”

“…In detail, endothelial dysfunction and the consequent reduced levels of NO and prostacyclin favor the activation of platelets, resulting in increased release of inflammatory and mitogenic mediators which further aggravate endothelial damage. Since the MPV is an index of platelet activity, it correlates with the presence of more thrombogenic platelets and accordingly with vascular pathologies including ED 45 . Indeed, the increase in mean platelet volume correlates with an approximately 2.28‐fold increase in the risk of developing CAD, with an increase in mortality following CAD and with a greater risk of restenosis after angioplasty.…”

Viscoelastic Hemostatic Assays and Platelet Function Testing in Patients with Atherosclerotic Vascular Diseases

“…In another study, high mean platelet volume—a simple indicator of platelet size that correlates with platelet activation and aggregability—was associated with a significantly increased incidence of long-term adverse events [ 15 ]. In addition, platelet dysfunction and abnormal (high) platelet activation or abnormal platelet aggregation is independently associated with the risk of ischemic stroke [ 16 , 17 , 18 ], lower limb ischemia [ 19 ], diabetic vascular disease [ 18 , 20 ] and vasculogenic erectile dysfunction [ 21 ]. Summarizing, platelet dysfunction with abnormal platelet activation and aggregation is connected with various cardiovascular ischemic diseases.…”