title: Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS).
abstract: Venous thromboembolism (VTE) is a frequent complication in cancer patients. Mean platelet volume (MPV) has been associated with arterial and venous thrombosis in patients without cancer. We analysed MPV in cancer patients and investigated the association of MPV with risk of VTE and mortality. MPV was routinely determined in the Vienna Cancer and Thrombosis Study, a prospective, observational cohort study of patients with newly diagnosed or progressive cancer after remission. Study endpoints were occurrence of symptomatic VTE or death during a maximum follow-up of two years. Out of 1,544 included patients, 114 (7.4%) developed VTE and 573 (37.1%) died during a median observation time of 576 days. High MPV ≥75th percentile of the study population; ≥10.8 fL) was associated with decreased risk of VTE compared to MPV below the 75th percentile (HR [95% CI]: 0.59 [0.37-0.95], p=0.031). In multivariable analysis, including age, sex, cancer groups, newly diagnosed vs recurrent disease, platelet count and soluble P-selectin, this association remained statistically significant (0.65 [0.37-0.98], p=0.041). Mortality of patients with MPV (≥75th percentile was significantly decreased compared to those with lower MPV (0.72 [0.59-0.88], p=0.001). Two-year probability of VTE and overall survival was 5.5% and 64.7% in patients with high MPV compared to 9% and 55.7% in those with lower MPV. In conclusion, high MPV is associated with decreased VTE risk and improved survival in cancer patients. This finding is contrary to results observed in patients without cancer. Further studies are needed to confirm our results and elucidate underlying mechanisms.
authors.forename: Julia
authors.initials: J
authors.lastname: Riedl
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kaider
authors.forename: Eva-Maria
authors.initials: EM
authors.lastname: Reitter
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Ulrich
authors.initials: U
authors.lastname: Jäger
authors.forename: Ilse
authors.initials: I
authors.lastname: Schwarzinger
authors.forename: Christoph
authors.initials: C
authors.lastname: Zielinski
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pabinger
authors.affiliation: Cihan Ay, MD, Clinical Division of Haematology and Haemostaseology, Department of Medicine I, Comprehensive Cancer Center, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria, Tel.: +43 1 40400 4410, Fax: +43 1 40400 4030, E-mail: cihan.ay@meduniwien.ac.at.
authors.forename: Cihan
authors.initials: C
authors.lastname: Ay
mesh_terms: D000368:Aged; D001317:Austria; D001792:Blood Platelets / Q000473:pathology; D002452:Cell Count; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D063847:Mean Platelet Volume / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality; D019007:P-Selectin / Q000097:blood; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D016019:Survival Analysis; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology* / Q000401:mortality
chemical_list: D019007:P-Selectin
keywords: Mean platelet volume; cancer; mortality; platelets; venous thromboembolism