title: Mean platelet volume is associated with lower risk of overall and non-vascular mortality in a general population. Results from the Moli-sani study.
abstract: Larger mean platelet volume (MPV) has been associated with adverse health outcomes in high-risk populations or patients with cardiovascular disease (CVD). We tested the association of MPV with mortality in a prospective cohort study including 17,402 subjects randomly recruited from an adult general population within the Moli-sani study (2005-2010). Two distinct subgroups (with or without CVD at baseline) were subsequently analysed. Hazard ratios (HR) were calculated using multivariable Cox-proportional hazard models. Over a median follow up of eight years (137,547 person-years), 925 all-cause deaths occurred (330 vascular, 351 cancer and 244 other deaths). In a multivariable model, the highest MPV quintile (mean MPV=10.0 fL), as compared to the lowest one, was associated with reduced risk of overall mortality (HR=0.79; 95 % confidence interval 0.64-0.98), cancer death (HR=0.70; 0.49-1.00) and death from other non- vascular/non cancer causes (HR=0.55; 0.36-0.84) but not with vascular mortality. The inverse association with overall death appeared even stronger in the subgroup without CVD at baseline (HR=0.64; 0.50-0.81). In contrast, within 920 subjects reporting a previous CVD event, larger MPV was associated with higher risk of total mortality (HR=1.69; 1.05-2.72; p for interaction=0.048) and with a trend of risk for other cause-specific deaths. In conclusion, larger MPV is associated with lower risk of overall and non-vascular death in subjects apparently free from CVD, but appears to be a predictive marker of death in patients with CVD history. The latter is a likely effect modifier of the association between MPV and death.
authors.forename: Marialaura
authors.initials: M
authors.lastname: Bonaccio
authors.forename: Augusto
authors.initials: A
authors.lastname: Di Castelnuovo
authors.forename: Simona
authors.initials: S
authors.lastname: Costanzo
authors.forename: Amalia
authors.initials: A
authors.lastname: de Curtis
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Persichillo
authors.forename: Chiara
authors.initials: C
authors.lastname: Cerletti
authors.forename: Maria Benedetta
authors.initials: MB
authors.lastname: Donati
authors.affiliation: Giovanni de Gaetano, MD, PhD, Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Via dell'Elettronica, 86077 Pozzilli (IS), Italy, Tel.: +39 0865915248, Fax: +39 0865927575, E-mail: giovanni.degaetano@neuromed.it, giovanni.degaetano@moli-sani.org.
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Gaetano
authors.forename: Licia
authors.initials: L
authors.lastname: Iacoviello
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000276:immunology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D063847:Mean Platelet Volume / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000276:immunology* / Q000401:mortality; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D016019:Survival Analysis
chemical_list: D015415:Biomarkers
keywords: Mean platelet volume; cardiovascular disease; cerebrovascular disease; epidemiology; mortality