The Mean Platelet Volume Is Decreased in Patients Diagnosed with Venous Thromboembolism in the Emergency Department

Abstract

Platelets are small corpuscular elements, which play an essential role in hemostasis and thrombosis. As active players in the thrombotic process, hyperactive platelets are involved in the pathogenesis of cardiovascular disorders. Nevertheless, the role of platelet size, as a biological marker of platelet activation, remains debated in the setting of venous thrombosis. Therefore, we conducted a retrospective case-control study to clarify the potential association between mean platelet volume (MPV) and newly diagnosed venous thromboembolism (VTE) by reviewing data of all consecutive patients receiving a diagnosis of VTE at the emergency department (ED) of the University Hospital of Parma (Italy) between January and December, 2014. The control population was represented by outpatients undergoing routine laboratory testing for health checkup at the phlebotomy center of the same University Hospital during the same period. MPV was found to be comparatively decreased in the entire cohort of patients with VTE compared with the outpatient population, as well as in those with isolated deep vein thrombosis (DVT) or pulmonary embolism (PE). A decreased MPV value (i.e., < 10.8 fL) was found to be associated with an increased risk of diagnosing VTE (relative risk, 1.18; 95% CI, 1.09–1.28; p < 0.001), as well as of diagnosing isolated DVT (relative risk, 1.19; 95% CI, 1.07–1.31; p = 0.001) and isolated PE (relative risk, 1.17; 95% CI, 1.04–1.30; p = 0.007). A decreased MPV value in active cancer patients was associated with the highest risk of diagnosing thrombosis (relative risk, 1.29; 95% CI, 1.10–1.51; p = 0.002). These results support an inverse association between MPV and the risk of venous thrombosis at diagnosis.

Keywords

venous thromboembolism - deep vein thrombosis - pulmonary embolism - platelets - mean platelet volume

• References

• 1 Lippi G, Franchini M, Targher G. Arterial thrombus formation in cardiovascular disease. Nat Rev Cardiol 2011; 8 (9) 502-512
• 2 Thachil J. Platelets in inflammatory disorders: a pathophysiological and clinical perspective. Semin Thromb Hemost 2015; 41 (6) 572-581
• 3 Klovaite J, Benn M, Yazdanyar S, Nordestgaard BG. High platelet volume and increased risk of myocardial infarction: 39,531 participants from the general population. J Thromb Haemost 2011; 9 (1) 49-56
• 4 Braekkan SK, Mathiesen EB, Njølstad I, Wilsgaard T, Størmer J, Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromsø Study, Tromsø, Norway. J Thromb Haemost 2010; 8 (1) 157-162
• 5 Gulcan M, Varol E, Etli M, Aksoy F, Kayan M. Mean platelet volume is increased in patients with deep vein thrombosis. Clin Appl Thromb Hemost 2012; 18 (4) 427-430
• 6 Riedl J, Kaider A, Reitter EM , et al. Association of mean platelet volume with risk of venous thromboembolism and mortality in patients with cancer. Results from the Vienna Cancer and Thrombosis Study (CATS). Thromb Haemost 2014; 111 (4) 670-678
• 7 Guyatt GH, Akl EA, Crowther M, Gutterman DD, Schuünemann HJ ; American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest 2012; 141 (2, Suppl) 7S-47S
• 8 Nurden AT. Platelet membrane glycoproteins: a historical review. Semin Thromb Hemost 2014; 40 (5) 577-584
• 9 McEwen BJ. The influence of diet and nutrients on platelet function. Semin Thromb Hemost 2014; 40 (2) 214-226
• 10 Chesnutt JK, Han HC. Platelet size and density affect shear-induced thrombus formation in tortuous arterioles. Phys Biol 2013; 10 (5) 056003
• 11 Lippi G, Carbucicchio A, Benatti M, Cervellin G. The mean platelet volume is decreased in patients with mild head trauma and brain injury. Blood Coagul Fibrinolysis 2013; 24 (7) 780-783
• 12 Wang RT, Li JY, Cao ZG, Li Y. Mean platelet volume is decreased during an acute exacerbation of chronic obstructive pulmonary disease. Respirology 2013; 18 (8) 1244-1248
• 13 Gunluoglu G, Yazar EE, Veske NS, Seyhan EC, Altin S. Mean platelet volume as an inflammation marker in active pulmonary tuberculosis. Multidiscip Respir Med 2014; 9 (1) 11
• 14 Erbis H, Aliosmanoglu I, Turkoglu MA, Ay E, Turkoglu A, Ulger BV. Evaluating mean platelet volume as a new indicator for confirming the diagnosis of necrotizing pancreatitis (e-pub ahead of print). Ann Ital Chir 2015; 86 . pii:S0003469 × 15022782
• 15 Mutlu H, Artis TA, Erden A, Akca Z. Alteration in mean platelet volume and platicrit values in patients with cancer that developed thrombosis. Clin Appl Thromb Hemost 2013; 19 (3) 331-333
• 16 Thompson CB, Eaton KA, Princiotta SM, Rushin CA, Valeri CR. Size dependent platelet subpopulations: relationship of platelet volume to ultrastructure, enzymatic activity, and function. Br J Haematol 1982; 50 (3) 509-519
• 17 Lippi G, Pavesi F, Pipitone S. Evaluation of mean platelet volume with four hematological analyzers: harmonization is still an unresolved issue. Blood Coagul Fibrinolysis 2015; 26 (2) 235-237