title: Mean platelet volume predicts embolic complications and prognosis in infective endocarditis.
abstract: OBJECTIVE
  This study was designed to examine the change in mean platelet volume (MPV) over the course of infective endocarditis (IE) and also the association between MPV and complications including embolic events in IE.
  
  
  METHODS
  Forty patients (26 male, mean age 46±15 years) who were hospitalized with a diagnosis of IE at the Department of Cardiology, Erciyes University, from March 2005 to August 2008, were retrospectively evaluated. The diagnosis of IE was made clinically and was confirmed with Duke's criteria. The erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein (hs-CRP), and MPV were measured before treatment and periodically during the follow-up period, until discharge.
  
  
  RESULTS
  There were 27 cases of native valve endocarditis and 13 of prosthetic valve endocarditis. While 31 patients were treated medically, an operation was performed in nine patients because of unsuccessful medical therapy. On admission, mean MPV was 10.8±1.1 fl, ESR was 82±26mm/h, and hs-CRP was 110±72mg/l. Seven patients died: one intraoperatively, three patients postoperatively, and three patients during medical treatment. With the exception of these seven patients, ESR and hs-CRP were significantly reduced in all patients at discharge compared to levels at hospitalization (ESR 82±26 to 32±22, p=0.001 and hs-CRP 110±72 to 25±15, p=0.001). Similarly, we detected a significant decrease in MPV from hospitalization to discharge, i.e., from the active period of the disease to recovery (10.8±1.1 to 9.7±0.8 fl, p=0.002). In addition, MPV was found to be significantly higher in patients with observed embolic complications (11.5 vs. 10.3 fl, p=0.001), other complications (11.0 vs. 10.2 fl, p=0.001), and death (11.1 vs. 10.4 fl, p=0.005).
  
  
  CONCLUSIONS
  MPV can be used as an activity criterion in IE, like ESR and hs-CRP. Also, high MPV is associated with a poor prognosis and adverse outcomes, and predicts complications including embolic events.
authors.affiliation: Department of Cardiology, Erciyes University School of Medicine, Talas, Kayseri, Turkey.
authors.forename: Ozgur
authors.initials: O
authors.lastname: Gunebakmaz
authors.forename: Mehmet Gungor
authors.initials: MG
authors.lastname: Kaya
authors.forename: Esma Gunduz
authors.initials: EG
authors.lastname: Kaya
authors.forename: Idris
authors.initials: I
authors.lastname: Ardic
authors.forename: Mikail
authors.initials: M
authors.lastname: Yarlioglues
authors.forename: Orhan
authors.initials: O
authors.lastname: Dogdu
authors.forename: Nihat
authors.initials: N
authors.lastname: Kalay
authors.forename: Mahmut
authors.initials: M
authors.lastname: Akpek
authors.forename: Bahadir
authors.initials: B
authors.lastname: Sarli
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Ozdogru
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000382:microbiology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D004617:Embolism / Q000209:etiology*; D004697:Endocarditis, Bacterial / Q000097:blood* / Q000150:complications* / Q000628:therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein