Mean platelet volume and major adverse cardiovascular events in congenital heart disease patients.

BACKGROUND: Platelet activation is linked with thrombosis, inflammation or heart failure. OBJECTIVE: To establish clinical and analytical factors that may favor high mean platelet volume (MPV) and to determine if MPV levels favor major adverse cardiovascular events (MACE). METHODS: Stable CHD patients and a control population matched for age, sex and cardiovascular factors. RESULTS: 658 CHD patients and 2092 controls were studied. Median age in CHD patients was 33 (25-41) year old with 56% of them being male. No significant differences were seen between MPV values and cardiac complexity (p = 0.308) nor between MPV values in the CHD and control groups (p = 0.911). CHD patients had significant lower platelet count and MPV levels than patients in the control group. In the binary logistic regression analysis NT-pro-BNP levels above 125 pg/ml, thrombocytopenia and having atrial fibrillation/flutter reached statistical significance as predictors of MPV levels above 11 fL. The Kaplan-Meier survival analysis showed no significance between MPV levels higher than 11 fL and MACE, cardiovascular mortality and thrombotic events in a median time follow-up of 6.7(1.5-10.6) years. CONCLUSIONS: Atrial fibrillation/flutter, heart failure and thrombocytopenia are predictors of high MPV levels. A MPV above 11 fL is not associated with MACE at a median follow-up time.

Is there a relationship between penile vasculogenic erectile dysfunction, platelet functions and eosinophil count? / Existe una relación entre la disfunción eréctil vasculogénica del pene, las funciones de plaquetas y el conteo de eosinófilos?

Purpose. Blood count parameters of patients referring with penile vasculogenic erectile dysfunction (ED) were examined in this study. It was investigated whether eosinophil count (EC), platelet count (PC) and mean platelet volume (MPV), values among the suspected predictive parameters which may affect vascular functions, have a contribution on ED pathology or not. Materials and methods. Patients referring erectile dysfunction complaint were evaluated. Depending on the medical story, ED degree was determined by measuring International Index of Erectile Function (IIEF). Values such as hormones, complete blood count and other laboratory markers were examined. Penile doppler ultrasonography (PDU) was performed in patients suspected to have vasculogenic ED. According to PDU result, patients with vascular deficiency were included in the penile vasculogenic ED group and patients with normal results were included in the control group. 49 patients participated in the study from the penile vasculogenic ED group and 30 patients from the control group. Intergroup comparisons were performed using the Mann-Whitney U test and the chi-square (χ2) test was used to assess the relationship between categorical variables within the patient groups. Results. Low IIEF score in vasculogenic ED group compared to the control group and high EC, MPV and PC values were detected to be statistically significant (p<0.001, p=0.026, p=0.009, p=0.029, respectively). No statistically significant difference was observed among the two groups when age, white blood cells, red blood cells or hemoglobin values are considered (p=0.332, p=0.235, p=0.127, p=0.696, respectively). Conclusion. High MPV value and platelet count showing the platelet functions and high eosinophil count are important factors which may play a role in penile vasculogenic ED etiopathogenesis (AU)

Propósito. Los parámetros de conteo de sangre de los pacientes referidos con disfunción eréctil (DE) vasculogénica del pene fueron examinados en este estudio. Se investigó si los valores de conteo de eosinófilos (CE), el conteo de plaquetas (CP) y el volumen plaquetario medio (VPM), entre los parámetros predictivos sospechados de afectar las funciones vasculares, contribuyen a la patología de DE o no. Materiales y métodos. Se evaluó a los pacientes referidos con quejas de DE. Dependiendo de su historial médico, el grado de DE fue determinado midiendo el índice internacional de función eréctil (IIFE). Se examinaron los valores de hormonas, el conteo total de sangre y otros valores de laboratorio. Se utilizó la ultrasonografía Doppler peneana (UDP) en pacientes en los que se sospechaba DE vasculogénica. Según el resultado de la UDP, los pacientes con deficiencia vascular fueron incluidos en el grupo de DE vasculogénica del pene y los pacientes con resultados normales fueron incluidos en el grupo de control. En el estudio participaron 49 pacientes en el grupo de DE vasculogénica del pene y 30 pacientes en el grupo de control. Las comparaciones intergrupales fueron realizadas utilizando el test U de Mann-Whitney y el test de la chi cuadrado (χ2) para analizar la relación entre los variable categóricos en los grupos de pacientes. Resultados. Resultados bajos de IIFE en el grupo de DE vasculogénica comparados con el grupo de control y resultados altos de CE, VPM y PC fueron detectados como estadísticamente significativos (p<0,001, p=0,026, p=0,009 y p=0,029, respectivamente). No se observó ninguna diferencia significativa estadísticamente entre los 2 grupos cuando se consideraron los valores de edad, glóbulos blancos, glóbulos rojos y hemoglobina (p=0,332, p=0,235, p=0,127 y p=0,696, respectivamente). Conclusión. Unos valores altos de VPM, un conteo de plaquetas que muestra las funciones de plaquetas y un conteo alto de eosinófilos son factores importantes que pueden desempeñar un papel en la etiopatogenia de la DE vasculogénica del pene (AU)

Reference intervals for mean platelet volume and immature platelet fraction determined on a sysmex XE5000 hematology analyzer.

BACKGROUND: New parameters describing the platelet population of the blood are mean platelet volume (MPV), which is a crude estimate of thrombocyte reactivity, and immature platelet fraction (IPF), which reflects megakaryopoietic activity. This study aimed to define reference intervals for MPV and IPF and to investigate whether separate reference intervals according to smoking status, age or sex are necessary. METHODS: Blood samples were obtained from subjects participating in The Danish General Suburban Population Study. MPV and IPF measurements were performed by the use of the Sysmex XE-5000 hematology analyzer. Reference intervals were established by a non-parametric method. RESULTS: In total, 1674 apparently healthy individuals (910 females and 764 males) were included. No significant age, sex or smoking status difference was observed. The reference interval was 9.6-13.1 fL for MPV and 1.3-9.0% for IPF, respectively. CONCLUSION: We have generated reference intervals for MPV and IPF in a large, adult Danish population and found those parameters remarkably stable across age, sex and smoking status.

Serial changes of mean platelet volume in relation to Killip Class in patients with acute myocardial infarction and primary percutaneous coronary intervention.

INTRODUCTION: Mean platelet volume (MPV) is related to the reactivity of platelets. Among survivors of acute myocardial infarction (MI), greater MPV is known to be associated with impaired reperfusion and higher mortality. The aims of the study is to investigate the dynamic changes of MPV and the relation between MPV and cardiac function in patients with acute MI and received primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: This retrospective cohort study included patients presented during January 2008 to March 2011 to Peking University Third Hospital with ST-segment elevation MI. All patients received successful PCI. MPV was measured serially, using a Sysmex XE2100 haematology analyser, from admission to day-7 after MI. RESULTS: In 375 patients, MPV was at its highest value (10.2±1.0 fL) and correlated well with platelet distribution width (PDW, r=0.833, p<0.0001) at the admission, and then reduced by 16% within the 24 hours, together with marked weakening of its correlation with PDW. Patients with poorer ventricular function, estimated by high Killip Class (≥2, n=96), had higher MPV values at all-time points. By logistic regression model and after adjusting for related confounders, high MPV remained as an independent predictor of Killip Class ≥2 (OR 1.873, CI 95% 1.373-2.673, p=0.001). Clopidogrel pre-usage resulted in significant MPV reduction on admission. CONCLUSIONS: MPV undergoes rapid and dynamic changes during the acute phase of MI, and was higher in patients with high Killip Class, suggesting a predictive value of MPV in ventricular dysfunction and clinical outcome of acute phase of MI.

Evaluation of mean platelet volume with four hematological analyzers: harmonization is still an unresolved issue.

The clinical applications of mean platelet volume (MPV) have recently broadened far beyond the differential diagnosis of platelet (PLT) disorders to embrace diagnosis and prognostication of a variety of thrombotic conditions. As the potential usefulness of this simple and inexpensive parameter may be challenged by instrument heterogeneity, we investigated the degree of analytical quality and interinstrument comparability. One hundred consecutive inpatient samples were simultaneously assessed on Abbott Sapphire, Mindray BC6800, Siemens Advia 2120, and Sysmex XE5000. The within-run imprecision of the four hematological analyzers was also assessed according to the Clinical and Laboratory Standards Institute document EP5-A2. The imprecision of PLT count ranged between 1.4 and 4.3%, and hence was always within the desirable quality specifications. The within-run imprecision of MPV ranged between 1.1 and 3.8%, and hence was also within the desirable quality specifications. The optical and impedance measurements displayed excellent correlations. Overall, the PLT count exhibited a modest instrumental variation, with bias always within the desirable quality specifications. A large bias was instead recorded for MPV, with between-instrument variations exceeding the desirable quality specifications in five out of six interinstrumental comparisons. No significant correlation was also observed between PLT count and MPV with any of the instruments tested. These results attest that although there is an optimal degree of analytical quality and comparability for PLT counting among different hemocytometers, the harmonization of MPV is poor, thus making the adoption of universal cutoffs virtually impossible.

Platelet count and plateletcrit in Cavalier King Charles Spaniels and Greyhounds using the Advia 120 and 2120.

BACKGROUND: Models for the regulation of thrombopoiesis predict that platelet mass is the biologically regulated variable, yet clinical evaluations of thrombopoiesis are often based on platelet number. When thrombocytopenia and variation in platelet size occur concurrently, platelet count may poorly estimate total platelet mass, confounding clinical decision making. OBJECTIVE: We hypothesized that plateletcrit (PCT) provides clinically important information when platelet number is an incomplete representation of platelet mass, such as in genetic macrothrombocytopenia. METHODS: We retrospectively compared platelet count and PCTs with general reference intervals for 4 groups of dogs: sick Cavalier King Charles Spaniels (CKCS) and Greyhounds, presented for nonhematopoietic disease to the University of Minnesota (measured using an Advia 2120) and Auburn University Teaching Hospitals (measured using an Advia 120) over a 3-year period. RESULTS: A canine PCT reference interval of 0.129-0.403% was established. None of the 4 sample groups had significantly more individuals below the reference interval for plateletcrit. For platelet count, only the 2 CKCS groups had significantly more individuals below the reference interval than predicted. CONCLUSION: Use of the PCT as determined by the Advia 120/2120 appeared to avoid overestimation of low platelet mass in sick CKCS in a clinical setting. In contrast, the PCT performed similarly to the platelet count in evaluation of platelet mass in sick Greyhounds. Evaluation of the PCT should be considered in other conditions associated with increased mean platelet volume.