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Mean platelet volume and coronary artery disease: a systematic review and meta-analysis
Nakarin Sansanayudh1, Thunyarat Anothaisintawee2, Dittaphol Muntham3
1Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
Insights
Mean platelet volume (MPV) is significantly larger in patients with coronary artery disease (CAD). Higher MPV levels are associated with increased odds of having CAD, suggesting its potential role in risk assessment.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biomarkers
Background:
- Platelets play a key role in coronary artery disease (CAD) pathophysiology.
- Mean platelet volume (MPV) is a potential indicator of platelet reactivity and CAD risk.
Purpose of the Study:
- To conduct a systematic review and meta-analysis on MPV in CAD.
- Compare MPV differences between CAD patients and controls.
- Assess the odds of CAD based on MPV levels.
Main Methods:
- Systematic review and meta-analysis of observational studies.
- Searched Medline and Scopus databases up to March 2013.
- Independent data selection and extraction by two reviewers.
Main Results:
- Forty studies included; MPV significantly higher in CAD patients (mean difference 0.70 fL).
- MPV higher in acute coronary events (0.84 fL) and chronic stable angina (0.46 fL).
- Higher MPV (≥7.3 fL) associated with 2.28 times greater odds of having CAD.
Conclusions:
- Elevated MPV is associated with coronary artery disease.
- MPV may aid in CAD risk stratification.
- Combining MPV with other factors could improve risk prediction models.
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).
Conclusion:
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.
