Mean Platelet Volume in Relation to Carotid Atherosclerosis in Normotensive, Euglycemic, and Normolipidemic Chinese Middle-Aged and Elderly Adults

Association of Mean Platelet Volume with Risk Factors and Functional Outcome in Acute Ischemic Stroke

Background  Stroke is the second leading cause of death in the world and a major cause of disability, with ischemic stroke contributing to 87% of all strokes. Platelets are central in the formation of thrombus, and in the process, they enlarge in size, become active, and secrete prothrombotic factors. This is supported by the presence of large platelets in ischemic stroke, where they may be implicated in the pathogenesis of vessel occlusion, leading to stroke. The mean platelet volume (MPV) is an important laboratory marker of platelet function and activation.

Materials and Methods  The present study was conducted to assess the role of MPV in the pathogenesis, severity, and outcome of ischemic stroke. It was an observational study in 100 acute ischemic stroke (AIS) patients (excluding cardioembolic stroke) admitted to the Medicine wards, Department of Medicine, Jawaharlal Nehru Medical College, a tertiary care hospital at Aligarh. The MPV was correlated with the conventional risk factors of ischemic stroke and outcome (using modified Rankin scale [mRS]). The study revealed statistically significant correlation between MPV and hypertension, type 2 diabetes mellitus, and carotid intima media thickness (CIMT). Also, the MPV at presentation positively correlated with mRS (correlation coefficient 0.818); thus, high MPV was associated with more severe disability.

Conclusion  The MPV at the time of presentation of ischemic stroke may be useful in predicting the severity of stroke and neurological recovery. However, a larger study including diverse population is required to endorse its predictive value in AIS.

Can Platelet Count and Mean Platelet Volume be Used as Markers of Postdural Puncture Headache in Obstetric Patients?

Objective

In this study, considering the importance of platelet function in inflammatory processes, we explored whether there are relationships of platelet indices with postdural puncture headache (PDPH) and pain developing after use of spinal needles and whether patient characteristics contribute to the development of PDPH.

Methods

This prospective, observational study included 76 patients (Group 1) with PDPH and 93 patients (Group 2) without PDPH. The postoperative hemoglobin, hematocrit, platelet count (PC), and mean platelet volume (MPV) values were recorded, along with age, blood type, Rh factor, gravida, parity, and gestational age. In addition, the time of the onset of pain was recorded in patients who complained of a postspinal headache.

Results

Hemoglobin and hematocrit values in Group 1 were significantly lower than in Group 2 (both, p=0.024). The PC of Group 1 was significantly higher than that of Group 2 (p < 0.001), whereas the MPV was significantly lower (p < 0.001). The area under the curve (AUC) values were significant for hemoglobin, hematocrit, PC, and MPV (p=0.022, p=0.024, p < 0.001, and p < 0.001, resp.). For MPV, the AUC value was 0.293, sensitivity was 1%, and specificity was 99%. The highest likelihood ratio (LR+) value was 1.22 at a cut-off value of 13.3 fL. For the PC, the AUC value was 0.666, the sensitivity was 9%, and the specificity was 99%, while the highest LR + value was 8.56 at a cut-off value of 352 × 10⁹/L. There was no significant relationship between the parameters examined and the onset of pain.

Conclusion

In this study, the PC was higher and MPV was lower in obstetric patients with PDPH compared with the control group. However, we also found that these two values cannot be used as markers of PDPH.

Importance of Mean Platelet Volume in Predicting Cardiac Mechanics Parameters and Carotid-Intima Media Thickness in Children With End-Stage Renal Disease and Comparison With Healthy Children

Cardiovascular disease (CVD) is the major cause of death in children with ESRD. Echocardiography and Doppler ultrasound are useful devices for diagnosing cardiovascular abnormalities in such patients. However, they are expensive, difficult to perform as a routine, and not available in many centers. Therefore, finding a more accessible and inexpensive method for CVD evaluation biomarkers is needed. The aim of this study was to evaluate the relationship between mean platelet volume (MPV) as a routine hematological parameter with cardiac mechanics characteristics in children with ESRD. Forty-two children under dialysis and 60 age- and sex-matched healthy subjects as control group were enrolled in the study. Carotid-intima media thickness (CIMT) and echocardiographic parameters were measured in both groups. In addition, hematological and biochemical variables were evaluated in blood samples of participants. MPV was significantly higher in patients than in controls. CIMT, left ventricular mass index (LVMI), end diastolic diameter, strain rate, and global longitudinal strain were significantly different between the two groups. MPV was positively correlated with LVMI and inversely with ejection fraction. In receiver operating characteristic (ROC) curve analysis, the area under the ROC curve (AUC) values for MPV in predicting left ventricular hypertrophy (LVH) and abnormal CIMT were 0.65 (P = 0.07) and 0.53 (P = 0.74), respectively. MPV was correlated with some cardiac abnormalities in children with ESRD. However, it could not show appropriate predictive values in diagnosing LVH and subclinical atherosclerosis. Further studies with prospective design could shed more light in this topic.

Which Is the Ideal Marker for Early Atherosclerosis in Obstructive Sleep Apnea (OSA) - Carotid Intima-Media Thickness or Mean Platelet Volume?

BACKGROUND Obstructive sleep apnea (OSA) is known to be closely associated with cardiovascular disease. Carotid intima-media thickness (IMT) is widely used for assessment of atherosclerosis. Mean platelet volume (MPV) is a new marker associated with atherothrombosis. In this study, we aimed to detect early atherosclerosis by measuring carotid intima-media thickness and to investigate the relationship between MPV and IMT and OSA severity. MATERIAL AND METHODS The study population consisted of 158 patients who underwent polysomnography and did not have any overt cardiac disease or risk factors. Carotid IMT was measured by ultrasonography. Blood samples were taken for MPV determination. Subjects were divided into 4 groups according to OSA severity: control, mild, moderate, and severe OSA. RESULTS CONCLUSIONS OSA patients appear to have increased carotid IMT suggestive of an atherosclerotic process. Carotid IMT could be a more useful indicator than MPV in these patients. Long-term prospective studies are needed to confirm these results.

The Relation Between Atherosclerosis and the Neutrophil–Lymphocyte Ratio

Inflammation plays an important role in the pathophysiology of vascular disease. In this review, we consider the associations between the neutrophil–lymphocyte ratio (NLR; an indicator of inflammation) and vascular disease and its associated risk factors. The NLR has received attention due to its role as an independent prognostic factor for coronary artery disease. The NLR can also be affected by atherosclerotic risk factors, such as hypercholesterolemia, metabolic syndrome, diabetes, and hypertension. Importantly, it can predict mortality in cardiovascular diseases. There are also reports of a positive correlation between the NLR and commonly used inflammatory markers. Inflammation is important not only in pathophysiology but also clinical outcomes of many diseases. The NLR is a widely available, easily derived, and reproducible marker of inflammation. Unlike many other inflammatory markers, the NLR is inexpensive and readily available and it provides additional risk stratification beyond conventional risk scores.

Prognostic value of mean platelet volume on tinnitus

OBJECTIVE

This study aimed to determine whether there was any relationship between tinnitus and mean platelet volume.

METHODS

This retrospective study was conducted between January 2013 and January 2014 in Ankara Atatürk Hospital and Ondokuz Mayıs University Hospital, Turkey, on a study group of 86 patients with tinnitus and a control group of 84 healthy subjects. Mean platelet volume was recorded and comparisons were made between the two groups.

RESULTS

Mean (± standard deviation) platelet volume was 7.67 ± 0.83 μm(3) in the study group and 7.28 ± 0.56 μm(3) in the control group. There was a statistically significant difference in mean platelet volume between the tinnitus patients and the healthy subjects (p < 0.05).

CONCLUSION

The clinical findings indicated that tinnitus patients had a higher mean platelet volume than the healthy control subjects; however, the pathophysiological mechanism remains unclear.

Rosuvastatin Decreases Mean Platelet Volume in Patients With Diabetes Mellitus

Statins have multiple effects (also known as pleiotropic effects) on inflammation, plaque stabilization, endothelial function, and hemostasis. We evaluated the effects of rosuvastatin on mean platelet volume (MPV)--a marker for platelet activity--in patients with diabetes mellitus (DM) on rosuvastatin medication. Patients (n = 178) who were to be prescribed high-intensity rosuvastatin were retrospectively enrolled according to their medical records. Baseline and 6-month biochemical tests, automated blood count, cell-volume analysis, and their cardiovascular risk factors were recorded. Rosuvastatin significantly reduced the MPV and the lipid parameters including total cholesterol, triglyceride, and low-density lipoprotein cholesterol (LDL-C). However, there was no correlation between MPV and LDL-C before (r = -.66; P = .383) and after (r = -.112; P = .135) rosuvastatin treatment or between ΔMPV and ΔLDL-C after 40 mg rosuvastatin daily therapy (r = -.155; P = .073). Rosuvastatin significantly decreases the MPV as well as cholesterol levels. The antiplatelet activation properties of high-dose rosuvastatin treatment in patients with DM are not lipid dependent.

Elevated neutrophil-to-lymphocyte ratio in Bell's palsy and its correlation with facial nerve enhancement on MRI

OBJECTIVE

The aim of this study was to investigate the role of inflammation and atherothrombosis in Bell's palsy (BP) by using neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), respectively, and to study their relations with the facial nerve enhancement on temporal gadolinium-enhanced magnetic resonance imaging (TGd-MRI).

STUDY DESIGN

Case control study.

SETTING

Tertiary health institution.

SUBJECTS AND METHODS

This study was performed on 65 patients who were diagnosed with BP and a control group of 35 healthy individuals. The BP patients were also divided into 2 groups, those with facial nerve enhancement on TGd-MRI and those without enhancement. The NLR and MPV of each group were compared.

RESULTS

The NLRs of the BP patients were significantly higher than control group (P = .001). The NLRs of patients with facial nerve enhancement on TGd-MRI were significantly higher than patients without enhancement (P = .001). There was a positive and significant correlation between NLR and House-Brackmann (HB) grade of the patients (r = 0.641; P < .05). MPV did not show any significant correlation with any of the parameters studied (P > .05).

CONCLUSION

NLR can be used as a new and important marker in BP since it is high in BP patients and significantly correlated with HB grade and facial nerve enhancement on TGd-MR. On the other hand, MPV does not have such correlations. These results offer evidence to support an inflammatory theory rather than microvascular response theory in the etiopatogenesis of BP.