The New Diagnostic Marker For Acute Pulmonary Embolism In Emergency Department; Mean Platelet Volume

Talay, Fahrettin; Ocak, Tarık; Alçelik, Aytekin; Erkuran, Kurşat; Akkaya, Akçan; Duran, Arif; Demırhan, Abdullah; Asuk, Zehra

doi:10.4314/ahs.v14i1.15

Cited by 16 publications

(19 citation statements)

References 19 publications

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“…Several studies have explored and demonstrated its diagnostic value in diagnosing acute PTE among the suspected patients. 18 Our findings were in line with the findings of Kostrubiec et al which reported MPV to be an independent predictor of mortality in patients with acute PTE. 19 A study by Günay et al showed that MPV and PDW can be useful in determining the severity of pulmonary vascular bed obstruction in PTE (i.e.…”

Section: Discussionsupporting

confidence: 93%

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P = 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes. Article info TUOMS P R E S SPlatelets indicies in acute pulmonary thromboembolism

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Section: Discussionsupporting

confidence: 93%

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Ghaffari

Parvizian

Pourafkari

et al. 2020

J Cardiovasc Thorac Res

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“…The PE is responsible for 5-10% of hospital mortality in general 2 , and can be increased up to 30% if not diagnosed and treated early, adding a 5% mortality caused by recurrence 3 . Some studies have shown that the high values of ProBNP, serum troponins, hyponatremia and lactate are associated with an increased mortality in patients with a thromboembolic event, just as a right ventricular dysfunction and the coexistence of PE with DVT 2,4,5 . The platelet size, measured as mean platelet volume (MPV), is a marker of platelet reactivity 5,6 , where larger platelets are hemostatically more reactive than normal sized platelets 1,5 .…”

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confidence: 99%

“…Some studies have shown that the high values of ProBNP, serum troponins, hyponatremia and lactate are associated with an increased mortality in patients with a thromboembolic event, just as a right ventricular dysfunction and the coexistence of PE with DVT 2,4,5 . The platelet size, measured as mean platelet volume (MPV), is a marker of platelet reactivity 5,6 , where larger platelets are hemostatically more reactive than normal sized platelets 1,5 . The association was demonstrated with platelet activity indicators, including the expression of glycoprotein Ib, glycoprotein receptor IIb/IIIa and the expression of higher levels of P-selectin 6,7 .…”

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confidence: 99%

Mean platelet volume as a prognostic factor for venous thromboembolic disease

et al. 2019

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Background: Mean platelet volume (MPV) is a risk factor for cardiovascular and inflammatory diseases. Aim: To evaluate the association between high MPV and 90-day mortality after an episode of venous thromboembolism (VTE). Material and Methods: Retrospective cohort of 594 patients with a median age of 73 years (58% women) with a first episode VTE, included in an institutional Thromboembolic Disease registry between 2014 and 2015. MPV values were obtained from the automated blood cell count measured at the moment of VTE diagnosis. Volumes ≥ 11 fL were classified as high. All patients were followed for 90 days to assess survival. Results: The main comorbidities were cancer in 221 patients (37%), sepsis in 172 (29%) and coronary artery disease in 107 (18%). Median MPV was 8 fl (8-9), brain natriuretic peptide 2,000 pg/ml (1,025-3,900) and troponin 40 pg/ml (19.5-75). Overall mortality was 20% (121/594) during the 90 days of follow-up. Thirty three deaths occurred within 7 days and 43 within the first month. The loss of patients from follow-up was 5% (28/594) at 90 days. Mortality among patients with high MP was 36% (23/63). The crude mortality hazard ratio (HR) for high MPV was 2.2 (95% confidence intervals (CI) 1.4-3.5).When adjusted for sepsis, oncological disease, heart disease, kidney failure and surgery, the mortality HR of high MPV was 2.4 (CI95% 1.5-3.9) in the VTE group, 2.3 (CI95% 1.5-4.4) in the deep venous thrombosis group, and 2.9 (CI95% 1.6-5.6) in the pulmonary embolism group. Conclusions: High MPV is an independent risk factor for mortality following an episode of VTE.

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“…In recently conducted studies on patients with PE, the elevation of NLR has been found to be correlated with early mortality [4]. Studies that examine MPV have determined that MPV was increased, platelet count was reduced in pulmonary embolism and these values were associated with the diameter of the right ventricle [5,6 ]. As far as we know there is no study in the medical literature that investigates the effect of PE treatment on hematological parameters.…”

Section: Introductionmentioning

confidence: 97%

The Prognostic Value of Hematological Parameters in Patients with Pulmonary Embolism

G�len¹

2017

Ann Clin Anal Med

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Anahtar KelimelerPulmoner Emboli; Beyaz Küre Sayısı; Nötrofil Lenfosit Oranı; Ortalama Trombosit Hacmi Abstract Aim: By analyzing the hemogram values of patients with PE during and following the treatment, the relationships of hematological parameters with response to treatment and prognosis of the disease were investigated. Material and Method: Forty-eight patients, who were hospitalized and treated with the diagnosis of PTE in the Pulmonary Diseases Clinic of our hospital between December 2014 and December 2015, were included in the study. The patients' charts, located in the digital archive system, were analyzed retrospectively and demographic characteristics, clinical evaluations, and their hemogram results during and following the treatment were retrospectively evaluated. Among the hemogram parameters, the values of WBC,NLR and MPV were statistically analyzed. For statistical analysis, SPSS 17.0 software and the Kolmogorov-Smirnov test, Mann-Whitney U test and independent sample t test were used. Results: The average age of the 48 patients included in our study was 62.68, and 27 (56.2%) of them were males. The average duration of hospitalization was 9.2 days. The median values of NLR, MPV, and WBC at the time of diagnosis were 4.82 (3.04-9.32), 10.2 (7.40-11.8), and 9215 (6507.5-13255), respectively. Following treatment, these values were 2.60 (1.82-3.74), 9.3 (7-12.9), and 7265 (6125-8872.5), respectively. It was determined that the NLR, MPV, and WBC values were statistically significantly reduced following treatment (p <0,001). Discussion: Our study suggested that NLR,MPV and WBC can be used as prognostic inflammatory indicators for diagnosing and treating pulmonary embolism.

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The New Diagnostic Marker For Acute Pulmonary Embolism In Emergency Department; Mean Platelet Volume

Cited by 16 publications

References 19 publications

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Prognostic value of platelet indices in patients with acute pulmonary thromboembolism

Mean platelet volume as a prognostic factor for venous thromboembolic disease

The Prognostic Value of Hematological Parameters in Patients with Pulmonary Embolism

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