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Galimzhanov A, Tenekecioglu E, Rustamova F, Tun HN, Mamas MA. The Prognostic Utility of Mean Platelet Volume in Patients With Acute Coronary Syndrome: A Systematic Review With Meta-Analyses. Angiology 2022; 73:734-743. [PMID: 35062842 DOI: 10.1177/00033197211070908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
Mean platelet volume (MPV) is a hematological index that is routinely measured in clinical settings. Although many studies have been conducted to investigate the prognostic significance of MPV in acute coronary syndromes (ACS), the findings have been inconsistent. The goal of this study was to systematically review all current evidence on the association between admission MPV and clinical outcomes after ACS. PubMed, Scopus, Web of Science, and other databases were searched. The primary endpoints were major adverse cardiovascular events (MACE) and mortality. We applied a Knapp and Hartung adjustment, prediction interval calculations and permutation tests during pairwise meta-analyses. A one-stage dose-response meta-analysis was also conducted. The meta-analysis consisted of 41 studies with 33443 participants. Mean platelet volume, as a continuous variable, was associated with the risk of long-term mortality (hazard ratio 1.33, 95% CI 1.19-1.48). After conducting permutation tests and calculation of prediction intervals, this association remained significant. The results for MACE were nonsignificant. Linear models were the best fitted models during dose-response meta-analyses, trends for nonlinearity were significant for long-term endpoints. Admission MPV was associated with long-term mortality in ACS patients, with nonlinear associations between MPV levels and long-term clinical outcomes.
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Affiliation(s)
- Akhmetzhan Galimzhanov
- Department of Cardiology and Interventional Arrhythmology, 373881Semey Medical University, Semey, Kazakhstan
| | - Erhan Tenekecioglu
- Department of Cardiology, Bursa Education and Research Hospital Health Sciences University, Bursa, Turkey
| | - Farida Rustamova
- Department of Internal Disease, 186045Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Han Naung Tun
- Larner College of Medicine, 12352University of Vermont, Burlington, VT, USA
| | - Mamas A Mamas
- Keele Cardiovascular Research Group Keele University, UK
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Wasilewski J, Desperak P, Hawranek M, Ciślak A, Osadnik T, Pyka Ł, Gawlita M, Bujak K, Niedziela J, Krawczyk M, Gąsior M. Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study. Platelets 2016; 27:452-8. [PMID: 26939525 DOI: 10.3109/09537104.2016.1143919] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Mean platelet volume (MPV) is a simple and reliable indicator of platelet size that correlates with platelet activation and their ability to aggregate. We studied the predictive value of MPV in patients with non-ST-segment elevation myocardial infarction (NSTEMI) treated with percutaneous coronary intervention (PCI). METHODS We analyzed the consecutive records of 1001 patients who were hospitalized due to NSTEMI at our center. The primary end point was a composite end point that included the rates of all-cause death, non-fatal myocardial infarction, and acute coronary syndrome (ACS) driven revascularization at 12 months. The enrolled patients were stratified according to the quartile of the MPV level at admission. RESULTS Along with the increasing quartile of MPV, the 12-month composite end point increased significantly (p = 0.010), and this association remained significant after the risk-adjusted analyses (per 1 fL higher MPV; adjusted hazard ratio [HR] 1.13; 95% confidence interval [CI] 1.02-1.27; p = 0.026). In the multivariate analysis, the MPV was also an independent factor of all-cause mortality (per 1 fL increase; adjusted HR 1.34; 95% CI 1.12-1.61; p = 0.0014) and death or non-fatal myocardial infarction (per 1 fL increase; adjusted HR 1.16; 95% CI 1.03-1.31; p = 0.017). CONCLUSION In patients with NSTEMI treated with PCI, a high MPV value was associated with a significantly increased incidence of long-term adverse events, particularly for all-cause mortality.
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Affiliation(s)
- Jarosław Wasilewski
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Piotr Desperak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Hawranek
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Aneta Ciślak
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Tadeusz Osadnik
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland.,c Genomics Laboratory, Kardio-Med Silesia Science and Technology Park , Zabrze , Poland
| | - Łukasz Pyka
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Marcin Gawlita
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Kamil Bujak
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Jacek Niedziela
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Michał Krawczyk
- b School of Medicine with the Division of Dentistry in Zabrze , Medical University of Silesia , Katowice , Poland
| | - Mariusz Gąsior
- a 3rd Chair and Department of Cardiology, SMDZ in Zabrze , Medical University of Silesia , Katowice , Poland
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Sansanayudh N, Numthavaj P, Muntham D, Yamwong S, McEvoy M, Attia J, Sritara P, Thakkinstian A. Prognostic effect of mean platelet volume in patients with coronary artery disease. A systematic review and meta-analysis. Thromb Haemost 2015; 114:1299-309. [PMID: 26245769 DOI: 10.1160/th15-04-0280] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2015] [Accepted: 06/17/2015] [Indexed: 12/22/2022]
Abstract
Large platelets with high haemostatic activity may lead to increased platelet aggregation.. Mean platelet volume (MPV), an indicator of platelet reactivity, may emerge as a prognostic marker in patients with coronary artery disease (CAD). It was the objective of this study to conduct a systematic review and meta-analysis to assess prognostic effects of MPV on cardiovascular events (CVE) in CAD patients. We searched MEDLINE and SCOPUS from inception to January 2, 2014. All studies that reported MPV and the incidence of cardiovascular events in CAD patients were included. Two reviewers independently extracted the data. A random-effects model was applied for pooling the mean difference of MPV between patients with vs without CVE. Among 30 eligible studies, eight studies reported mean difference of MPV between CVE groups, 11 studies reported MPV dichotomous into high vs low MPV groups, and 11 studies reported both. The pooled mean difference was 0.69 fL (95 %CI = 0.36, 1.01), i. e. patients with CVE had a MPV about 0.69 fL higher than non-CVE. Patients with higher MPV were about 12 % more likely to die than patients with lower MPV (RR 1.12; 95 %CI = 1.02-1.24). However, pooling these effects was based on high heterogeneity and the source of heterogeneity could not be identified. This might be explained by many differences among included studies (e. g. study population, outcomes of interest, analysate, time between blood collection and MPV analysis, etc). These findings suggest that MPV may be a useful prognostic marker in patients with CAD.
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Affiliation(s)
| | - Pawin Numthavaj
- Pawin Numthavaj, MD, Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 370 Rama VI road, Rajathevi, 10400 Bangkok, Thailand, Tel.: 6622011284, Fax: 6622011284, E-mail:
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Platelet/lymphocyte ratio was associated with impaired myocardial perfusion and both in-hospital and long-term adverse outcome in patients with ST-segment elevation acute myocardial infarction undergoing primary coronary intervention. ADVANCES IN INTERVENTIONAL CARDIOLOGY 2015; 11:288-97. [PMID: 26677378 PMCID: PMC4679796 DOI: 10.5114/pwki.2015.55599] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 06/07/2015] [Accepted: 08/11/2015] [Indexed: 02/08/2023] Open
Abstract
Introduction Platelet/lymphocyte ratio (PLR) has been shown to be an inflammatory and thrombotic biomarker for coronary heart disease, but its prognostic value in ST-segment elevation myocardial infarction (STEMI) has not been fully investigated. Aim To investigate the relationship between PLR and no-reflow, along with the in-hospital and long-term outcomes in patients with STEMI. Material and methods In the present study, we included 304 consecutive patients suffering from STEMI who underwent primary percutaneous coronary intervention (p-PCI). Patients were stratified according to PLR tertiles based on the blood samples obtained in the emergency room upon admission. No-reflow after p-PCI was defined as a coronary thrombolysis in myocardial infarction (TIMI) flow grade ≤ 2 after vessel recanalization, or TIMI flow grade 3 together with a final myocardial blush grade (MBG) < 2. Results The mean follow-up period was 24 months (range: 22–26 months). The number of patients characterized with no-reflow was counted to depict increments throughout successive PLR tertiles (14% vs. 20% vs. 45%, p < 0.001). In-hospital major adverse cardiovascular events and death increased as the PLR increased (p < 0.001, p < 0.001). Long-term MACE and death also increased as the PLR increased (p < 0.001, p < 0.001). Multivariable logistic regression analysis revealed that PLR remained an independent predictor for both in-hospital (OR = 1.01, 95% CI: 1.00–1.01; p = 0.002) and major long-term (OR = 1.01, 95% CI: 1.00–1.01; p < 0.001) adverse cardiac events. Conclusions Platelet/lymphocyte ratio on admission is a strong and independent predictor of both the no-reflow phenomenon and long-term prognosis following p-PCI in patients with STEMI.
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Misumida N, Kobayashi A, Fox JT, Kanei Y. Does mean platelet volume predict the location of the infarct-related artery in non-ST-segment elevation myocardial infarction patients? Platelets 2014; 26:706-9. [DOI: 10.3109/09537104.2014.997691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ayça B, Akin F, Çelik Ö, Yüksel Y, Öztürk D, Tekiner F, Çetin Ş, Okuyan E, Dinçkal M H. Platelet to lymphocyte ratio as a prognostic marker in primary percutaneous coronary intervention. Platelets 2014; 26:638-44. [PMID: 25350375 DOI: 10.3109/09537104.2014.968117] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
We assessed the prognostic value of the platelet to lymphocyte ratio (PLR) in primary percutaneous coronary intervention (pPCI). Patients (n = 440) with acute myocardial infarction (AMI) who underwent pPCI were divided into 2 groups: low PLR (<137) and high PLR (>137). "Thrombolysis In Myocardial Infarction" (TIMI) flow grades and Syntax scores (SXS) were calculated from initial angiograms. In-hospital mortality rate and cardiac adverse events were obtained from medical records. Patients with high PLR had more no-reflow, higher SXS and higher mortality rate (p < 0.001, p < 0.001 and p = 0.008, respectively). In receiver operating characteristic curve analysis, high PLR predicted development of no-reflow (specificity 71% and sensitivity 85%), SXS>22 (specificity 52% and sensitivity 61%) and adverse events (specificity 67% and sensitivity 63%). In multivariate regression analysis, PLR was an independent risk factor for no-reflow, SXS>22 and in-hospital adverse events. In addition to PLR, we present the relationship between mean platelet volume, red cell distribution width and neutrophil to lymphocyte ratio and no-reflow, SXS and in-hospital adverse events.
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Affiliation(s)
- Burak Ayça
- a Department of Cardiology , Bağcilar Education and Research Hospital , Istanbul , Turkey
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Incebiyik A, Seker A, Vural M, Gul Hilali N, Camuzcuoglu A, Camuzcuoglu H. May mean platelet volume levels be a predictor in the diagnosis of pelvic inflammatory disease? Wien Klin Wochenschr 2014; 126:422-6. [PMID: 24958650 DOI: 10.1007/s00508-014-0560-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Accepted: 05/02/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Our aim in this study was to investigate whether mean platelet volume (MPV) value could be used as an early marker to predict pelvic inflammatory disease (PID). METHODS Overall, 44 patients with PID and 44 healthy women were included in the study. The control group consisted of 44 women who applied to the clinic for a routine gynaecological check-up, without chronic disease or a history of medication use. Owing to the fact that it would affect thrombocyte function, women who have the following conditions were excluded from the study: women who were taking anticoagulant therapy, oral contraceptives, nonsteroid anti-inflammatory medications and who had chronic diseases. The leukocyte count, platelet count, neutrophil ratio and MPV values were collected from PID and the control group. C reactive protein values of patients with PID were also noted. RESULTS MPV values in patients with PID were lower than those in the control group. This reduction in MPV is statistically significant when the PID patient group is compared with the control group (p < 0.001). A negative correlation was discovered between platelet count and MPV values (p = 0.019, r = - 0.425). Receiver-operating curve analysis pointed out that MPV has greater area under curve value than neutrophil rate, leukocyte and platelet count (0.73, 0.64, 0.72 and 0.49 respectively). CONCLUSION Since the MPV value was significantly decreased in patients with PID, it may serve as an additional and even more valuable marker than leukocyte count in the diagnosis of PID.
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Affiliation(s)
- Adnan Incebiyik
- Faculty of Medicine, Department of Gynecology and Obstetrics, Harran University, Yenisehir Campus, 63300, Sanlıurfa, Turkey,
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Niu X, Yang C, Zhang Y, Zhang H, Yao Y. Mean platelet volume on admission improves risk prediction in patients with acute coronary syndromes. Angiology 2014; 66:456-63. [PMID: 24848783 DOI: 10.1177/0003319714536024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Our aim was to evaluate the incremental predictive value of adding mean platelet volume (MPV) to the Global Registry of Acute Coronary Events (GRACE) risk score. The MPV and GRACE score were determined on admission in 509 consecutive patients with acute coronary syndrome (ACS). Six-month mortality or nonfatal myocardial infarction (MI) was the study end point. Overall, 61 (12%) patients reached the combined end point. Cox multivariate analysis showed that an elevated MPV was an independent predictor of 6-month mortality or MI in patients with ACS. The addition of MPV to the GRACE model improved its global fit and discriminatory capacity. The new model including MPV allowed adequate reclassification of 16% of the patients. In conclusion, the inclusion of MPV into the GRACE risk score could allow improved risk classification, thereby refining risk stratification of patients with ACS.
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Affiliation(s)
- Xiaowei Niu
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Cuiling Yang
- School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yiming Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Hengliang Zhang
- The First Clinical Medical School, Lanzhou University, Lanzhou, Gansu, China
| | - Yali Yao
- Department of Cardiology, the First Hospital of Lanzhou University, Lanzhou, Gansu, China
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