Mean platelet volume and the extent of coronary artery disease: results from a large prospective study.
BACKGROUND
Platelets play a central role in the pathogenesis of coronary artery disease. Mean platelet volume (MPV) is an indicator of platelet activation, and has been demonstrated to be correlated with platelet reactivity. The aim of the current study was to investigate whether mean platelet volume is associated with the extent of coronary artery disease.


METHODS
We measured MPV in 1411 consecutive patients undergoing coronary angiography. All angiograms were analyzed by two investigators blinded of clinical data. Significant coronary artery disease was defined as stenosis >50% in at least 1 coronary vessel. We additionally measured Carotid Intima-Media Thickness (IMT) in 359 patients. The relationship between MPV and platelet aggregation was evaluated by PFA-100 in 50 consecutive patients who were not taken any antiplatelet therapy, and in a cohort of patients who were on aspirin by PFA-100 (n=161) and Multiplate (n=94).


RESULTS
Patients were divided into three groups according to tertiles of MPV. Patients with higher MPV were slightly older (p=0.038), with larger prevalence of diabetes (p<0.0001), hypertension (p=0.008), previous CVA (p=0.041), less often with stable angina (p=0.043) and family history of CAD (p=0.011), more often on statins (p=0.012), and diuretics (p=0.007). MPV was associated with baseline glycaemia (p<0.0001) and red blood cell count (p=0.056), but inversely related to platelet count (p<0.0001). MPV was not associated with the extent coronary artery disease (p=0.71) and carotid IMT (p=0.9). No relationship was found between MPV and platelet aggregation.


CONCLUSIONS
This study showed that MPV is not related to platelet aggregation, the extent of coronary artery disease and carotid IMT. Thus, this parameter cannot be considered as a marker of platelet reactivity or a risk factor for coronary artery disease.
Division of Cardiology, Azienda Ospedaliera-Universitaria Maggiore della Carità, Eastern Piedmont University, Corso Mazzini 18, Novara, Italy. giuseppe.deluca@maggioreosp.novara.it
Giuseppe
G
De Luca
Matteo
M
Santagostino
Gioel Gabrio
GG
Secco
Ettore
E
Cassetti
Livio
L
Giuliani
Elena
E
Franchi
Lorenzo
L
Coppo
Sergio
S
Iorio
Luca
L
Venegoni
Elisa
E
Rondano
Gabriele
G
Dell'Era
Claudia
C
Rizzo
Patrizia
P
Pergolini
Francesco
F
Monaco
Giorgio
G
Bellomo
Paolo
P
Marino
D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets / Q000473:pathology*; D002339:Carotid Arteries / Q000648:ultrastructure; D048429:Cell Size; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood*; D006801:Humans; D015539:Platelet Activation / Q000502:physiology; D010974:Platelet Aggregation / Q000187:drug effects; D011446:Prospective Studies; D017539:Tunica Intima / Q000648:ultrastructure; D017540:Tunica Media / Q000648:ultrastructure
D001241:Aspirin