Objective:Mean platelet volume (MPV) plays a pivotal role in the pathophysiology of atherosclerotic disease. Thoracic aortic intima-media thickness (IMT) was reported as an earlier marker of preclinical atherosclerosis than carotid IMT. However, the relationship between MPV and aortic IMT was not investigated. We aimed to assess the relationship between thoracic aortic IMT and MPV in patients undergoing transesophageal echocardiography (TEE) examination for different indications.Methods:We studied 190 patients (mean age 37.0±12.5 years) who underwent TEE for different indications. The patients who have known atherosclerotic disease were excluded from study. The patients were divided into 2 groups according to the median thoracic aortic IMT values (IMTlow group <13 mm and IMThigh group ≤13 mm). Platelet count and MPV were analyzed with an automated hematology analyzer. A multiple stepwise linear regression analysis was performed to identify the independent associations of thoracic aortic IMT.Results:The highest MPV values were observed in the IMThigh group compared with the IMTlow group (9.5±10 fL vs. 10.9±1.2 fL, p<0.001). Also, the IMThigh group had higher age, hs-CRP and uric acid levels (p<0.05 for all). Multiple linear regression analysis showed that aortic IMT was independently related with age (β=0.340, p<0.001), uric acid (β=0.111, p=0.041), hs-CRP (β=0.200, p<0.001), and MPV (β=0.482, p<0.001).Conclusion:MPV is independently related to the extent of subclinical thoracic aortic atherosclerosis. Increases in MPV may be a crucial biochemical marker for initial atherosclerosis.