Sansanayudh Nakarin, Anothaisintawee Thunyarat, Muntham Dittaphol, McEvoy Mark, Attia John, Thakkinstian Ammarin
Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand.
Cardiology Unit, Department of Internal Medicine, Phramongkutklao Hospital, Bangkok, Thailand; Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Int J Cardiol. 2014 Aug 20;175(3):433-40. doi: 10.1016/j.ijcard.2014.06.028. Epub 2014 Jun 28.
Platelets with high hemostatic activity play an important role in the pathophysiology of coronary artery disease(CAD) and mean platelet volume(MPV) has been proposed as an indicator of platelet reactivity. Thus, MPV may emerge as a potential marker of CAD risk. The aim of this study was to conduct a systematic review and meta-analysis comparing mean difference in MPV between patients with CAD and controls and pooling the odds ratio of CAD in those with high versus low MPV.
Medline and Scopus databases were searched up to 12 March 2013. All observational studies that considered MPV as a study's factor and measured CAD as an outcome were included. Two reviewers independently selected the studies and extracted the data.
Forty studies were included in this meta-analysis. The MPV was significantly larger in patients with CAD than controls with the unstandardized mean difference of 0.70 fL (95% CI: 0.55, 0.85). The unstandardized mean difference of MPV in patients with acute coronary event and in patients with chronic stable angina was 0.84 fL (95% CI: 0.63, 1.04) and 0.46 fL (95% CI: 0.11, 0.81) respectively. Patients with larger MPV (≥7.3 fL) also had a greater odds of having CAD than patients with smaller MPV with a pooled odds ratio of 2.28 (95% CI: 1.46, 3.58).
Larger MPV was associated with CAD. Thus, it might be helpful in risk stratification, or improvement of risk prediction if combining it with other risk factors in risk prediction models.
具有高止血活性的血小板在冠状动脉疾病(CAD)的病理生理学中起重要作用,平均血小板体积(MPV)已被提议作为血小板反应性的指标。因此,MPV可能成为CAD风险的潜在标志物。本研究的目的是进行一项系统评价和荟萃分析,比较CAD患者与对照组之间MPV的平均差异,并汇总高MPV与低MPV患者患CAD的比值比。
检索截至2013年3月12日的Medline和Scopus数据库。纳入所有将MPV作为研究因素并将CAD作为结局进行测量的观察性研究。两名评价者独立选择研究并提取数据。
本荟萃分析纳入了40项研究。CAD患者的MPV显著大于对照组,未标准化平均差异为0.70 fL(95%CI:0.55,0.85)。急性冠状动脉事件患者和慢性稳定型心绞痛患者的MPV未标准化平均差异分别为0.84 fL(95%CI:0.63,1.04)和0.46 fL(95%CI:0.11,0.81)。MPV较大(≥7.3 fL)的患者患CAD的几率也高于MPV较小的患者,汇总比值比为2.28(95%CI:1.46,3.58)。
较大的MPV与CAD相关。因此,如果将其与风险预测模型中的其他风险因素相结合,可能有助于风险分层或改善风险预测。