Platelets have a predominant role in the pathogenesis of Acute Coronary Syndromes (ACS). It is believed that the mean platelet size, evaluated by the mean platelet volume (MPV), is a sensitive indicator of platelet reactivity and thrombogenicity potential. Many studies found association between the MPV and the ACS or the occurrence of Acute Myocardial Infarction (AMI). The reasons for this are not well known, but may be due to platelet aggregation or consumption.
The aim of this study was to evaluate the MPV in Coronary diseases patients and correlate it with risk factors to these diseases.
The patients included were those who would be submitted to procedures like coronariography, angioplasty and myocardial bypass. They were evaluated by a hemogram with the MPV and answered to a questionary about risk factors to coronary disease.
We observed that all patients (N=72) had an elevated MPV, ranging from 9.1 to 13,7 and a mean of 11,57fL. The mean age was 63,4 years, being 32% women and 68% men. The mean MPV in the female group was slightly higher than in the men group (11,95 fL vs 11,39), but not statistically significant.(p=0,09) The relation between risk factors and the MPV was as follows: High Corporeal Mass Index had a higher mean MPV (11,63 vs 11,46fl), but no statistically significance was found.(p=0,24) When asked about Hypertension, Diabetes and Dislipidemia, 88,9% confirmed at least one of these diseases, and had a mean MPV higher than those without them. (11,6vs11,3fl) (p<0,0001) When each group, with one of these diseases were compared with the group without them, we observed that the group with diabetes had a higher MPV (11,46 vs 11,30fl)(p=0,01), the same happening with the hypertension group (11,60 vs 11,30fl)(p<0,0001), and in the group of dislipidemic patients, in whom we observed the higher mean value (12,3 vs 11,30 fl)(p=0,019) We could not find differences between the MPV of smokers and no smokers (11,60 vs 11,63 fL)(p=0,9080). The history of previous Myocardial Infarction did not correlate with a higher MPV (11,56 vs 11,61fl)(p=0,41) The family history of coronary diseases did correlate with a higher mean MPV. (11,61vs11,46)(p=0,0201). At last, the use o one anti-aggregating agent was associated with a lower MPV (11,57vs11,59)(p=0,0012).
It was expected that all patients had an elevated MPV, and this is observed in some publications. The explanation for these results is linked to the fact that all patients in the study had coronary arterial diseases and probably higher platelet consumption. This consumption stimulates the production of larger platelets, increasing the MPV. The risk factors are highly associated with coronary diseases and that is why they were associated with a higher mean MPV too. The MPV comes with a simple hemogram and is easily done, has no contra-indications, and with a very low cost can be used as a marker of coronary disease.
No relevant conflicts of interest to declare.
Asterisk with author names denotes non-ASH members.