Aims: Recently, mean platelet volume (MPV) was reported to predict venous thromboembolism. Moreover, MPV correlates with platelet reactivity and indicates poor outcome in acute coronary syndromes. We hypothesized that in acute pulmonary embolism (APE) MPV is elevated and may predict mortality.
Methods and results: The study included consecutive 192 patients with APE, (79M/113F, 64±18yrs) and 100 controls matched for age, sex and concomitant diseases. On admission blood samples were collected for MPV and troponin measurements. Although MPV did not differ between APE and controls (10.0±1.2 vs.10.1±0.8fl), it differed between low and intermediate or high risk APE (9.4±1.2fl, 10.3±1.1fl, 10.3±1.8 fl; respectively, p<0.0001). Eighteen (9%) APE patients died during 30-day observation. MPV was higher in non-survivors than survivors (10.7±1.4fl vs. 9.9±1.2fl, p<0.01). The areas under ROC curves of MPV were 0.658(95%CI:0.587-0.725) for predicting 30-day mortality, and 0.712(95%CI:0.642-0.775) for 7-day mortality. MPV>10.9fl, showed sensitivity, specificity, PPV and NPV for death within 30 days (39%,81%,18%,93%, respectively) and for 7-day mortality (54%, 82%, 18%, 96%). Multivariable analysis revealed MPV was the independent mortality predictor for 7- and 30-day all-cause mortality (HR 2.0[CI95%:1.3-3.0, p<0.001] and 1.7[CI95%:1.2-2.5, p<0.01], respectively). MPV were higher in patients with myocardial injury than in those without troponin elevation (10.2±1.1fl vs. 9.8±1.2fl; p=0.02). There were correlations between MPV and right ventricle (RV) diameter and RV dysfunction (r=0.28,p<0.01 and r=0.19,p<0.02, respectively).
Conclusion: MPV is an independent predictor of early death in APE. Moreover, MPV in APE is associated with right ventricular dysfunction and myocardial injury.
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