title: Mean platelet volume and coronary artery disease: a systematic review and meta-analysis.
abstract: BACKGROUND
  Platelets with high hemostatic activity play an important role in the pathophysiology of coronary artery disease(CAD) and mean platelet volume(MPV) has been proposed as an indicator of platelet reactivity. Thus, MPV may emerge as a potential marker of CAD risk. The aim of this study was to conduct a systematic review and meta-analysis comparing mean difference in MPV between patients with CAD and controls and pooling the odds ratio of CAD in those with high versus low MPV.
  
  
  METHODS
  Medline and Scopus databases were searched up to 12 March 2013. All observational studies that considered MPV as a study's factor and measured CAD as an outcome were included. Two reviewers independently selected the studies and extracted the data.
  
  
  RESULTS
  Forty studies were included in this meta-analysis. The MPV was significantly larger in patients with CAD than controls with the unstandardized mean difference of 0.70 fL (95% CI: 0.55, 0.85). The unstandardized mean difference of MPV in patients with acute coronary event and in patients with chronic stable angina was 0.84 fL (95% CI: 0.63, 1.04) and 0.46 fL (95% CI: 0.11, 0.81) respectively. Patients with larger MPV (≥7.3 fL) also had a greater odds of having CAD than patients with smaller MPV with a pooled odds ratio of 2.28 (95% CI: 1.46, 3.58).
  
  
  CONCLUSIONS
  Larger MPV was associated with CAD. Thus, it might be helpful in risk stratification, or improvement of risk prediction if combining it with other risk factors in risk prediction models.
authors.affiliation: Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
authors.forename: Nakarin
authors.initials: N
authors.lastname: Sansanayudh
authors.affiliation: Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand; Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand. Electronic address: thunyarat.ano@mahidol.ac.th.
authors.forename: Thunyarat
authors.initials: T
authors.lastname: Anothaisintawee
authors.affiliation: Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Dittaphol
authors.initials: D
authors.lastname: Muntham
authors.affiliation: Centre for Clincial Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of New Castle, NSW, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: McEvoy
authors.affiliation: Centre for Clincial Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health and Medicine, University of New Castle, NSW, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Attia
authors.forename: Ammarin
authors.initials: A
authors.lastname: Thakkinstian
authors.affiliation: Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.lastname: AmmarinThakkinstian
mesh_terms: D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D006801:Humans; D063847:Mean Platelet Volume / Q000379:methods*; D064887:Observational Studies as Topic; D010976:Platelet Count / Q000379:methods; D012307:Risk Factors
keywords: Coronary artery disease; Mean platelet volume; Meta-analysis; Systematic review