Galimzhanov Akhmetzhan, Tun Han Naung, Sabitov Yersyn, Perone Francesco, Kursat Tigen Mustafa, Tenekecioglu Erhan, Mamas Mamas A
Department of Propedeutics of Internal Disease, Semey Medical University, Semey, Kazakhstan.
Keele Cardiovascular Research Group, Keele University, Keele, UK.
Eur J Clin Invest. 2024 Dec;54(12):e14295. doi: 10.1111/eci.14295. Epub 2024 Jul 31.
Mean platelet volume (MPV) is a widely available laboratory index, however its prognostic significance in patients with coronary artery disease (CAD) is still unclear. We intended to investigate and pool the evidence on the prognostic utility of admission MPV in predicting clinical outcomes in patients with CAD.
PubMed, Web of Science, and Scopus were the major databases used for literature search. The risk of bias was assessed using the quality in prognostic factor studies. We used random-effects pairwise analysis with the Knapp and Hartung approach supported further with permutation tests and prediction intervals (PIs).
We identified 52 studies with 47,066 patients. A meta-analysis of nine studies with 14,864 patients demonstrated that one femtoliter increase in MPV values was associated with a rise of 29% in the risk of long-term mortality (hazard ratio [HR] 1.29, 95% confidence interval [CI] 1.22-1.37) in CAD as a whole. The results were further supported with PIs, permutation tests and leave-one-out sensitivity analyses. MPV also demonstrated its stable and significant prognostic utility in predicting long-term mortality as a linear variable in patients treated with percutaneous coronary intervention (PCI) and presented with acute coronary syndrome (ACS) (HR 1.29, 95% CI 1.20-1.39, and 1.29, 95% CI 1.19-1.39, respectively).
The meta-analysis found robust evidence on the link between admission MPV and the increased risk of long-term mortality in patients with CAD patients, as well as in patients who underwent PCI and patients presented with ACS.
平均血小板体积（MPV）是一项广泛可用的实验室指标，然而其在冠状动脉疾病（CAD）患者中的预后意义仍不明确。我们旨在调查并汇总关于入院时MPV对CAD患者临床结局预测效用的证据。
PubMed、Web of Science和Scopus是用于文献检索的主要数据库。使用预后因素研究的质量评估偏倚风险。我们采用随机效应成对分析以及Knapp和Hartung方法，并通过置换检验和预测区间（PI）进一步支持。
我们纳入了52项研究，共47066例患者。对9项研究共14864例患者的荟萃分析表明，在总体CAD患者中，MPV值每增加1飞升，长期死亡风险升高29%（风险比[HR] 1.29，95%置信区间[CI] 1.22 - 1.37）。这些结果通过PI、置换检验和留一法敏感性分析得到进一步支持。在接受经皮冠状动脉介入治疗（PCI）且患有急性冠状动脉综合征（ACS）的患者中，MPV作为线性变量在预测长期死亡方面也显示出稳定且显著的预后效用（HR分别为1.29，95% CI 1.20 - 1.39和1.29，95% CI 1.19 - 1.39）。
荟萃分析发现了有力证据，证明入院时MPV与CAD患者、接受PCI的患者以及患有ACS的患者长期死亡风险增加之间存在关联。
