Faber Julie, Hvas Anne-Mette, Kristensen Steen Dalby, Grove Erik Lerkevang, Adelborg Kasper
Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus, Denmark.
Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.
Thromb Haemost. 2021 May;121(5):659-675. doi: 10.1055/s-0040-1721386. Epub 2020 Dec 10.
Immature platelets are larger and may be more thrombogenic than mature platelets. This systematic review included studies on the association between mean platelet volume (MPV), immature platelet count (IPC), and immature platelet fraction (IPF) and the risk of major cardiovascular events (MACEs) in patients with acute coronary syndrome (ACS) or stable coronary artery disease (CAD).
The literature search included studies in PubMed, Embase, Web of Science, and Cochrane Library. The review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Effect estimates that included multivariate adjusted odds ratios, relative risks, or hazard ratios were extracted.
Forty-two studies were identified. High MPV was positively associated with MACE in 20 of 26 studies of patients with ACS, four of five studies in patients with stable CAD, and in all six studies comprising a combined population with ACS and stable CAD. Using continuous models of MPV in patients with ACS, effect estimates varied from 0.90 (95% confidence interval [CI]: 0.95-1.03) to 1.66 (95% CI: 1.32-2.09). The strength of these associations was broadly similar among patients with stable CAD and in combined populations. Five studies investigated IPC or IPF as exposures and all reported positive associations with MACE among patients with ACS, stable CAD, or in combined populations.
This review demonstrated clear evidence for positive associations between measures of immature platelets and subsequent risk of MACE in acute and stable ischemic heart disease patients.
未成熟血小板比成熟血小板更大，且可能具有更强的致血栓形成能力。本系统评价纳入了关于急性冠状动脉综合征（ACS）或稳定型冠状动脉疾病（CAD）患者中平均血小板体积（MPV）、未成熟血小板计数（IPC）和未成熟血小板分数（IPF）与主要心血管事件（MACE）风险之间关联的研究。
文献检索包括在PubMed、Embase、Web of Science和Cochrane图书馆中进行的研究。该评价按照系统评价和Meta分析的首选报告项目（PRISMA）声明进行。提取包括多变量调整比值比、相对风险或风险比在内的效应估计值。
共识别出42项研究。在26项ACS患者研究中的20项、5项稳定型CAD患者研究中的4项以及所有6项包含ACS和稳定型CAD联合人群的研究中，高MPV与MACE呈正相关。在ACS患者中使用MPV的连续模型，效应估计值从0.90（95%置信区间[CI]：0.95 - 1.03）到1.66（95%CI：1.32 - 2.09）不等。这些关联的强度在稳定型CAD患者和联合人群中大致相似。5项研究将IPC或IPF作为暴露因素进行调查，所有研究均报告在ACS患者、稳定型CAD患者或联合人群中，IPC或IPF与MACE呈正相关。
本评价表明，有明确证据显示未成熟血小板指标与急性和稳定型缺血性心脏病患者随后发生MACE的风险之间存在正相关。
