Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu, China.
Department of Cardiology, Northern Jiangsu People's Hospital, No. 98, Nantong West Road, Yangzhou, 225001, Jiangsu, China.
BMC Cardiovasc Disord. 2020 May 20;20(1):241. doi: 10.1186/s12872-020-01525-x.
Mean platelet volume (MPV) has been identified as an individual risk factor for stroke and thrombosis. Concurrently, ischaemic stroke caused by nonvalvular atrial fibrillation (AF) has attracted increasing attention. The aim of this study was to investigate the association between MPV and the risk of ischaemic stroke in AF patients not receiving anticoagulant therapy.
A total of 370 patients with nonvalvular AF were enrolled. Patients were divided into a control group and a stroke group according to the presence of ischaemic stroke.
The MPV level and CHA2DS2-VASc scores of the stroke group were higher than those of the control group (all p < 0.001). The ischaemic stroke event rates were significantly increased in the highest MPV tertile when compared to the lowest MPV tertile (56.9% vs. 30.3%, p < 0.001). Multivariate logistic regression analysis showed that CHA2DS2-VASc, MPV and D-dimer (D2) were predictors of ischaemic stroke [all p < 0.05]. The receiver operating characteristic (ROC) curve analysis indicated that an MPV value of 11.65 fL could predict ischaemic stroke with a sensitivity of 67.3% and specificity of 58.5%, while a CHA2DS2-VASc score cutoff value 3.5 had a sensitivity of 52.1% and specificity of 87.3%. The predictive value of the combined model of CHA2DS2-VASc+MPV was higher than others (comparison calculated by using MedCalc software). The sensitivity of the CHA2DS2-VASc score combined with MPV for predicting ischaemic stroke was 72.1%, and the specificity was 81.5%.
MPV could be a new predictor of ischaemic stroke risk in patients with AF. Moreover, the CHA2D2S2-VASc combined with MPV can improve predictive value with higher sensitivity and it could be a powerful tool for stratifying patients in terms of ischaemic stroke risk.
平均血小板体积（MPV）已被确定为中风和血栓形成的个体危险因素。同时，非瓣膜性心房颤动（AF）引起的缺血性中风引起了越来越多的关注。本研究旨在探讨非接受抗凝治疗的 AF 患者的 MPV 与缺血性中风风险之间的关系。
共纳入 370 例非瓣膜性 AF 患者。根据是否存在缺血性中风，将患者分为对照组和中风组。
中风组的 MPV 水平和 CHA2DS2-VASc 评分均高于对照组（均 P<0.001）。与最低 MPV 三分位相比，MPV 最高三分位的缺血性中风发生率显著增加（56.9% vs. 30.3%，P<0.001）。多变量 logistic 回归分析显示，CHA2DS2-VASc、MPV 和 D-二聚体（D2）是缺血性中风的预测因素（均 P<0.05）。受试者工作特征（ROC）曲线分析表明，MPV 值为 11.65 fL 可预测缺血性中风，其敏感性为 67.3%，特异性为 58.5%，而 CHA2DS2-VASc 评分截断值为 3.5 时的敏感性为 52.1%，特异性为 87.3%。CHA2DS2-VASc+MPV 联合模型的预测价值高于其他模型（使用 MedCalc 软件计算比较）。CHA2DS2-VASc 评分联合 MPV 预测缺血性中风的敏感性为 72.1%，特异性为 81.5%。
MPV 可作为 AF 患者缺血性中风风险的新预测指标。此外，CHA2D2S2-VASc 联合 MPV 可提高预测价值，具有更高的敏感性，可能是一种评估缺血性中风风险的有力工具。
