Dahan Shani, Plakht Ygal, Shiyovich Arthur, Ben Assa Eyal, Almazzada Farrukh, Melamed Guy, Nahir Barak, Gazit Sivan, Patalon Tal, Lev Eli
Division of Cardiology, Assuta Ashdod Medical Center, Ashdod, Israel.
Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Int J Cardiol Cardiovasc Risk Prev. 2025 Oct 23;27:200535. doi: 10.1016/j.ijcrp.2025.200535. eCollection 2025 Dec.
Altered platelet function contributes to the prothrombotic state in type 2 diabetes mellitus (DM), potentially influencing long-term cardiovascular risk. Mean platelet volume (MPV), a readily available marker of platelet size and activity, has been linked to adverse cardiovascular outcomes, yet its prognostic value in DM is less defined. This study evaluated the association between MPV and the composite MPV × platelet count (MPV × PLT) with long-term cardiovascular outcomes in patients with DM without prior myocardial infarction (MI) or stroke.
This retrospective cohort study used anonymized data from 88,710 patients with DM and no prior history of MI or stroke. Patients were classified into three equal-sized groups based on MPV and MPV*PLT values, with additional analysis of the lowest and highest 5 % of values. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE), a composite of all-cause mortality, MI, and stroke.
During a median follow-up of 8.9 years, a total of 8,828 (10.0 %) MACCE events occurred. MACCE rates were highest in the lowest (13.1 %) and highest (10.0 %) MPV groups (p < 0.001). Both low and high MPV × PLT values were independently associated with greater MACCE risk versus the middle group (adjusted hazard ratio 1.22, 95 % CI 1.11-1.33; and hazard ratio 1.47, 95 % CI 1.33-1.63; both p < 0.001).
Extreme MPV and MPV × PLT values were independently associated with adverse long-term cardiovascular outcomes in patients with DM. These findings suggest that MPV and MPV × PLT may serve as cost-effective, readily available biomarkers for improving cardiovascular risk stratification in this high-risk population.
血小板功能改变促成了2型糖尿病（DM）的血栓前状态，可能影响长期心血管风险。平均血小板体积（MPV）是一种易于获得的血小板大小和活性标志物，已与不良心血管结局相关联，但其在糖尿病中的预后价值尚不明确。本研究评估了无既往心肌梗死（MI）或中风的糖尿病患者中MPV以及MPV×血小板计数（MPV×PLT）与长期心血管结局之间的关联。
这项回顾性队列研究使用了88710例无MI或中风病史的糖尿病患者的匿名数据。根据MPV和MPV*PLT值将患者分为三个等规模组，并对最低和最高5%的值进行了额外分析。主要结局是主要不良心脑血管事件（MACCE），即全因死亡率、MI和中风的综合指标。
在中位随访8.9年期间，共发生8828例（10.0%）MACCE事件。MACCE发生率在最低（13.1%）和最高（10.0%）MPV组中最高（p<0.001）。与中间组相比，低和高MPV×PLT值均与更高的MACCE风险独立相关（调整后的风险比为1.22，95%CI为1.11-1.33；风险比为1.47，95%CI为1.33-1.63；两者p<0.001）。
极端的MPV和MPV×PLT值与糖尿病患者不良的长期心血管结局独立相关。这些发现表明，MPV和MPV×PLT可能作为经济有效且易于获得的生物标志物，用于改善这一高危人群的心血管风险分层。
