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Mean platelet volume and long-term cardiovascular outcomes in patients with type 2 diabetes mellitus

Shani Dahan1,2,3, Ygal Plakht2, Arthur Shiyovich4

  • 1Division of Cardiology, Assuta Ashdod Medical Center, Ashdod, Israel.

International Journal of Cardiology. Cardiovascular Risk and Prevention
|November 10, 2025
PubMed
Abstract

Insights

In type 2 diabetes, extreme mean platelet volume (MPV) and MPV x platelet count (MPV x PLT) levels are linked to higher risks of major adverse cardiac and cerebrovascular events (MACCE). These readily available markers can improve cardiovascular risk assessment in diabetic patients.

Area of Science:

  • Cardiology
  • Hematology
  • Endocrinology

Background:

  • Altered platelet function in type 2 diabetes mellitus (DM) contributes to a prothrombotic state, increasing cardiovascular risk.
  • Mean platelet volume (MPV) is a marker of platelet activity, but its prognostic value in DM requires further definition.
  • This study investigates MPV and MPV x platelet count (MPV x PLT) as predictors of cardiovascular outcomes in DM patients without prior cardiovascular events.

Purpose of the Study:

  • To evaluate the association between MPV and MPV x PLT with long-term cardiovascular outcomes in patients with type 2 diabetes.
  • To determine if MPV and MPV x PLT can serve as useful biomarkers for cardiovascular risk stratification in diabetic individuals.

Main Methods:

  • A retrospective cohort study of 88,710 patients with DM and no history of myocardial infarction (MI) or stroke.
  • Patients were grouped based on MPV and MPV x PLT values.
  • The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), including all-cause mortality, MI, and stroke, over a median follow-up of 8.9 years.

Main Results:

  • MACCE rates were significantly higher in both the lowest and highest MPV groups (p < 0.001).
  • Both low and high MPV x PLT values were independently associated with increased MACCE risk compared to the middle group (adjusted HRs 1.22 and 1.47, respectively; p < 0.001).

Conclusions:

  • Extreme MPV and MPV x PLT values are independently associated with adverse long-term cardiovascular outcomes in patients with type 2 diabetes.
  • MPV and MPV x PLT represent cost-effective and accessible biomarkers for enhancing cardiovascular risk assessment in high-risk diabetic populations.
Keywords:
Cardiovascular riskMajor adverse cardiac and cerebrovascular events (MACCE)Mean platelet volume (MPV)Platelet count (PLT)Platelet functionPreventionType 2 diabetes mellitus

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