Platelet Indices and Risk of Death and Cardiovascular Events: Results from a Large Population-Based Cohort Study

Abstract

Studies evaluating the relationship between platelet indices and cardiovascular (CV) outcomes yielded conflicting results. We assessed the incidence of adverse events according to baseline quintiles of platelet indices in the prospective cohort of the Malmö Diet and Cancer Study. A total of 30,314 individuals (age 57 ± 8 years) were followed for a median of 16 years (468,490 person-years). Outcome measures included all-cause death, CV death, myocardial infarction (MI), and ischemic stroke. The fifth quintile of platelet count (> 274.6 × 109/L) was associated with higher incidence of all-cause death (hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.09–1.32, p < 0.001), CV death (HR 1.19, 95% CI 1.00–1.42; p = 0.044), MI (HR 1.32, 95% CI 1.12–1.54; p = 0.001), and ischemic stroke (HR 1.27, 95% CI 1.08–1.50, p = 0.004) compared with the first quintile (≤ 185 × 109/L), and also associated with a lower survival, regardless of previous history of MI (p for interaction = 0.58) or stroke (p for interaction = 0.42). In the highest quintile, history of stroke had a higher risk of CV death (HR 3.18, 95% CI 1.54–6.54) compared with no previous stroke (HR 1.12, 95% CI 0.96–1.31). The risk of MI and stroke was greatest in the fifth quintile, regardless of previous MI or previous stroke, respectively. The risk of all adverse events was similar across different quintiles of mean platelet volume. In conclusion, elevated platelet count is associated with higher mortality and risk of CV events, regardless of previous MI and stroke. Platelet count may thus be a useful marker for further stratification of CV risk, and especially of death.

High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture

“…PLR is a simple inflammatory marker that does not need any additional laboratory testing, and easily calculated by the platelet count/lymphocyte count formula. According to several population-based cohort studies, increased platelet counts had a significant association with mortality, risk of cardiovascular disease, and dementia [24][25][26]. In patients with hip fracture, Galivanche et al [27] reported that high platelet counts were a risk factor for developing a post-operative pressure ulcer.…”

Differential effects of testosterone on circulating neutrophils, monocytes, and platelets in men: Findings from two trials

“…14 However, there are no randomized trial data on the effects of exogenous testosterone on circulating leukocytes and platelets. Because of the known association of increased leukocyte [15][16][17][18] and platelet counts [19][20][21] with cardiovascular and thromboembolic risk, these findings, if confirmed in human studies, could affect the safety of testosterone treatment. These findings could also provide important clues to the site of testosterone's action in the bone marrow.…”

“…The findings of increased platelet count observed in the 5aR should be further evaluated in larger trials because higher platelet counts, even within the normal range, are associated with an increased risk of ischemic stroke, and cardiovascular and all-cause death. [19][20][21] Increased platelet counts are associated with risk of venous thromboembolism during recovery from acute illness and in cancer patients. 35 This study has several strengths and some limitations.…”

Large and small platelets—(When) do they differ?

“…Finally, the long‐term risk of cardiovascular morbidity and mortality may not be associated with MPV. Recently, Patti et al found the risk of adverse cardiovascular events similar across different MPV quintiles 113 …”