Mean platelet volume (MPV) and incident myocardial infarction and ischemic stroke: A Literature Review

Abstract

Background: Myocardial infarction (MI) and ischemic stroke (IS) are leading causes of death worldwide. Traditional risk factors, including hypertension, dyslipidemia, smoking and diabetes, account for the majority of the MI and IS cases. However, the disease burden remains substantial, and research for discovering novel risk factors has been ongoing, and large platelets can be a potential candidate. Large platelets, as reflected by an increased mean platelet volume (MPV), has a greater prothrombotic potential compared with small platelets. MPV serves as a marker for platelet function and has been extensively investigated as a prognostic biomarker for people with MI or IS. However, whether MPV is a risk factor for incident MI and IS remains uncertain.

Aim: To perform a review of the existing literature on the potential role of MPV as a risk factor for incident MI and IS.

Methods: A structured literature search was conducted in Medline (February 2023) to identify studies involving an adult population and with a prospective design on the association of MPV with MI or IS. The identified articles were screened with predefined inclusion criteria by title and abstract, or by full-text assessment.

Results: Of 569 identified records, 4 prospective cohort studies were included. Two studies found an association between MPV and the outcomes of interest, where an MPV ≥7.4 fL vs. MPV <7.4 fL yielded a HR for incident MI of 1.38 (95% CI 1.08-1.75) and an MPV <7.3 fL vs. MPV 7.3-10.3 fL yielded a HR for incident IS of 0.79 (95% CI 0.65-0.97). The two last studies did not find an association between MPV and the studied outcome. The four included studies had an overall moderate to high risk of bias.

Conclusion: This literature review shows that the available data on the topic is still scarce, and more studies are warranted to establish the role of platelet size, as reflected by MPV, for the risk of incident MI or IS and in the pathophysiology of both diseases.