title: Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Chu
authors.forename: R C
authors.initials: RC
authors.lastname: Becker
authors.forename: P B
authors.initials: PB
authors.lastname: Berger
authors.forename: D L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: J W
authors.initials: JW
authors.lastname: Eikelboom
authors.forename: B
authors.initials: B
authors.lastname: Konkle
authors.forename: E R
authors.initials: ER
authors.lastname: Mohler
authors.forename: M P
authors.initials: MP
authors.lastname: Reilly
authors.forename: J S
authors.initials: JS
authors.lastname: Berger
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000401:mortality; D001792:Blood Platelets / Q000473:pathology*; D048429:Cell Size; D003324:Coronary Artery Disease / Q000097:blood / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000097:blood / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000209:etiology* / Q000401:mortality; D016017:Odds Ratio; D010976:Platelet Count; D010979:Platelet Function Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
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