Mean platelet volume and clinical outcomes in patients with acute ischemic stroke: A systematic review and meta-analysis
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Updated: Feb 26, 2026
Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Miguel Cabanillas-Lazo1, Claudia Cruzalegui-Bazán2,3, Renzo Vallejos-Esquen2,3
1Grupo de Investigación Neurociencias, Metabolismo, Efectividad Clínica y Sanitaria (NEMECS), Universidad Científica del Sur, Lima, Perú.
Objective:
Mean platelet volume (MPV) is a laboratory marker that reflects platelet activity and has been linked to a higher risk of thromboembolic events. This study aimed to evaluate MPV as a potential biomarker for clinical outcomes in acute ischemic stroke.
Methods:
A systematic search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar up to March 2024. Risk of bias was assessed using the Newcastle-Ottawa Scale. When meta-analysis was not feasible, a narrative synthesis was performed. Subgroup and sensitivity analyses were planned, and the certainty of evidence was graded using the GRADE approach.
Results:
Out of 534 studies, 57 were included (10,979 patients). Higher MPV levels were associated with poor functional outcomes (modified Rankin Scale [mRS] >2) at 90 days, although with high heterogeneity (MD: 0.50; 95% CI: 0.31-0.70; I2=82%). A weak positive correlation was found between MPV and impairment measure (National Institutes of Health Stroke Scale [NIHSS]: r=0.140-0.221). MPV was also associated with mortality at 3 months (OR: 3.88) and 1 year (OR: 1.76). No significant associations were observed with one-year disability, hemorrhagic transformation, cerebral microbleeds, or in-hospital complications.
Conclusions:
In summary, MPV may be associated with worse 90-day functional outcomes and mortality; however, its correlation with impairment severity measured by NIHSS was weak. Further studies are needed to establish optimal cut-off values and incorporate MPV into predictive models.
Insights
Mean platelet volume (MPV) may predict poor outcomes and mortality in acute ischemic stroke patients. However, its correlation with stroke severity is weak, requiring further research for clinical application.
Area of Science:
- Neurology
- Hematology
- Biomarker Research
Background:
- Mean platelet volume (MPV) is a marker of platelet activation.
- Elevated MPV is linked to increased risk of thromboembolic events.
- The role of MPV in acute ischemic stroke outcomes requires further elucidation.
Purpose of the Study:
- To evaluate Mean platelet volume (MPV) as a potential biomarker for clinical outcomes in acute ischemic stroke.
- To synthesize current evidence on the association between MPV and stroke prognosis.
Main Methods:
- Systematic literature search across major databases (PubMed, Embase, Scopus, Web of Science, Google Scholar) up to March 2024.
- Risk of bias assessment using the Newcastle-Ottawa Scale.
- Meta-analysis where feasible, otherwise narrative synthesis; planned subgroup, sensitivity, and GRADE analyses.
Main Results:
- 57 studies (10,979 patients) included; higher MPV associated with poor 90-day functional outcomes (mRS >2) with high heterogeneity.
- Weak positive correlation between MPV and NIHSS scores (r=0.140-0.221).
- MPV linked to increased mortality at 3 months (OR: 3.88) and 1 year (OR: 1.76); no significant association with disability, hemorrhagic transformation, or complications.
Conclusions:
- MPV may indicate worse functional outcomes and mortality in acute ischemic stroke.
- The correlation between MPV and stroke severity (NIHSS) is weak.
- Further research is needed to define MPV cut-off values and its role in predictive models for stroke.
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