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Lung

, Volume 195, Issue 4, pp 497–502 | Cite as

Predictive Value of Mean Platelet Volume for Pulmonary Embolism Recurrence

  • Omer ArazEmail author
  • Fadime Sultan Albez
  • Elif Yilmazel Ucar
  • Bugra Kerget
  • Nafiye Yılmaz
  • Metin Akgun
Article

Abstract

Purpose

Recurrence is a major clinical problem in patients with pulmonary embolism and can affect mortality. The decision to discontinue treatment is important for recurrence and is based on patients’ clinical features as well as certain blood parameters. Our aim in this study was to evaluate whether mean platelet volume (MPV) and platelet distribution width (PDW) have utility as new predictive parameters for recurrence and mortality in pulmonary embolism.

Materials and Methods

A total of 440 patients with pulmonary embolism underwent computed tomography, Doppler ultrasonography, and echocardiography before and at the conclusion of treatment. Thrombocyte count, MPV, PDW, and D-dimer parameters were also evaluated at the same time points.

Results

MPV and PDW were significantly higher in deceased patients (8.8 ± 1.2 fl and 17.4 ± 0.8) compared to surviving patients (7.7 ± 0.9 fl and 17 ± 0.9) (p < 0.0001). Initial MPV and PDW were also significantly higher in patients with recurrence (8.4 ± 0.7 vs 7.6 ± 0.8 fl, p < 0.0001 and 17.3 ± 0.8 vs 16.9 ± 0.9, p = 0.002, respectively) than in patients without recurrence. At the end of treatment, MPV was still higher in patients with recurrence compared to patients without recurrence (8.7 ± 0.5 and 7.5 ± 0.7 fl, respectively, p < 0.0001). MPV values over 8.05 fl at the end of treatment predicted recurrence with 91% sensitivity and 77% specificity.

Conclusion

MPV seems to be an indicator of recurrence in pulmonary embolism and may have utility in the prediction of recurrence. Elevated MPV can also be used to predict mortality in pulmonary embolism.

Keywords

Pulmonary embolism Mean platelet volume Platelet distribution width Recurrence 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors received no financial support for the research and/or authorship of this article. The authors declare that they have no conflict of interest to the publication of this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Limbrey R, Howard L (2015) Developments in the management and treatment of pulmonary embolism. Eur Respir Rev 24(137):484–497CrossRefPubMedGoogle Scholar
  2. 2.
    Torbicki A, Perrier A, Konstantinides S, Agnelli G, Galiè N, Pruszczyk P, Bengel F, Brady AJ, Ferreira D, Janssens U (2008) Guidelines on the diagnosis and management of acute pulmonary embolism. Eur Heart J 29(18):2276–2315CrossRefPubMedGoogle Scholar
  3. 3.
    Heit JA (2015) Epidemiology of venous thromboembolism. Nat Rev Cardiol 12(8):464–474CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Dow R (1994) The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci 15:12–15Google Scholar
  5. 5.
    Rowan R (1986) Platelet size distribution analysis: principles techniques and potential clinical utility. Hematol Rev 1:109–144Google Scholar
  6. 6.
    Hilal E, Neslihan Y, Gazi G, Sinan T, Ayfer AZ (2013) Does the mean platelet volume have any importance in patients with acute pulmonary embolism? Wien Klin Wochenschr 125(13–14):381–385CrossRefPubMedGoogle Scholar
  7. 7.
    Icli A, Aksoy F, Turker Y, Uysal BA, Alpay MF, Dogan A, Nar G, Varol E (2015) Relationship between mean platelet volume and pulmonary embolism in patients with deep vein thrombosis. Heart Lung Circ 24(11):1081–1086CrossRefPubMedGoogle Scholar
  8. 8.
    Akgüllü Ç, Ömürlü İK, Eryılmaz U, Avcil M, Dağtekin E, Akdeniz M, Güngör H, Zencir C (2015) Predictors of early death in patients with acute pulmonary embolism. Am J Emerg Med 33(2):214–221CrossRefPubMedGoogle Scholar
  9. 9.
    Ageno W, Squizzato A, Wells P, Büller H, Johnson G (2013) The diagnosis of symptomatic recurrent pulmonary embolism and deep vein thrombosis: guidance from the SSC of the ISTH. J Thromb Haemost 11(8):1597–1602CrossRefPubMedGoogle Scholar
  10. 10.
    Boutitie F, Pinede L, Schulman S, Agnelli G, Raskob G, Julian J, Hirsh J, Kearon C (2011) Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants’ data from seven trials. BMJ 342:d3036CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Poli D, Miniati M (2011) The incidence of recurrent venous thromboembolism and chronic thromboembolic pulmonary hypertension following a first episode of pulmonary embolism. Curr Opin Pulm Med 17(5):392–397CrossRefPubMedGoogle Scholar
  12. 12.
    Lijfering WM, Rosendaal FR, Cannegieter SC (2010) Risk factors for venous thrombosis–current understanding from an epidemiological point of view. Br J Haematol 149(6):824–833CrossRefPubMedGoogle Scholar
  13. 13.
    Douketis J, Tosetto A, Marcucci M, Baglin T, Cosmi B, Cushman M, Kyrle P, Poli D, Tait RC, Iorio A (2011) Risk of recurrence after venous thromboembolism in men and women: patient level meta-analysis. BMJ 342:d813CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Eichinger S, Heinze G, Jandeck LM, Kyrle PA (2010) Risk assessment of recurrence in patients with unprovoked deep vein thrombosis or pulmonary embolism the vienna prediction model. Circulation 121(14):1630–1636CrossRefPubMedGoogle Scholar
  15. 15.
    Nijkeuter M, Tick LW, Kamphuisen PW, Kramer MH, Laterveer L, van Houten AA, Kruip MJ, Leebeek FW, Huisman MV (2007) The natural course of hemodynamically stable pulmonary embolism: clinical outcome and risk factors in a large prospective cohort study. CHEST J 131(2):517–523CrossRefGoogle Scholar
  16. 16.
    Connors JM (2013) Extended treatment of venous thromboembolism. N Engl J Med 368(8):767–769CrossRefPubMedGoogle Scholar
  17. 17.
    Schulman S, Kearon C, Kakkar AK, Schellong S, Eriksson H, Baanstra D, Kvamme AM, Friedman J, Mismetti P, Goldhaber SZ (2013) Extended use of dabigatran, warfarin, or placebo in venous thromboembolism. N Engl J Med 368(8):709–718CrossRefPubMedGoogle Scholar
  18. 18.
    Agnelli G, Buller HR, Cohen A, Curto M, Gallus AS, Johnson M, Porcari A, Raskob GE, Weitz JI (2013) Apixaban for extended treatment of venous thromboembolism. N Engl J Med 368(8):699–708CrossRefPubMedGoogle Scholar
  19. 19.
    Tong M, Seth P, Penington D (1987) Proplatelets and stress platelets. Blood 69(2):522–528PubMedGoogle Scholar
  20. 20.
    Thompson CB, Jakubowski JA (1988) The pathophysiology and clinical relevance of platelet heterogeneity. Blood 72(1):1–8PubMedGoogle Scholar
  21. 21.
    Bessman J, Gilmer P, Gardner F (1984) Use of mean platelet volume improves detection of platelet disorders. Blood cells 11(1):127–135Google Scholar
  22. 22.
    Young L, Ockelford P, Milne D, ROLFE-VYSON V, Mckelvie S, Harper P (2006) Post-treatment residual thrombus increases the risk of recurrent deep vein thrombosis and mortality. J Thromb Haemost 4(9):1919–1924CrossRefPubMedGoogle Scholar
  23. 23.
    Lindmarker P, Schulman S (2000) The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. J Intern Med 247(5):601–606CrossRefPubMedGoogle Scholar
  24. 24.
    Bath P, Butterworth R (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinol 7(2):157–161CrossRefGoogle Scholar
  25. 25.
    Martin J, Trowbridge E, Salmon G, Plumb J (1983) The biological significance of platelet volume: its relationship to bleeding time, platelet thromboxane B 2 production and megakaryocyte nuclear DNA concentration. Thromb Res 32(5):443–460CrossRefPubMedGoogle Scholar
  26. 26.
    Chait Y, Condat B, Cazals-Hatem D, Rufat P, Atmani S, Chaoui D, Guilmin F, Kiladjian JJ, Plessier A, Denninger MH (2005) Relevance of the criteria commonly used to diagnose myeloproliferative disorder in patients with splanchnic vein thrombosis. Br J Haematol 129(4):553–560CrossRefPubMedGoogle Scholar
  27. 27.
    Araz O, Yilmazel Ucar E, Yalcin A, Kelercioglu N, Meral M, Gorguner AM, Akgun M (2014) Predictive value of serum Hs-CRP levels for outcomes of pulmonary embolism. Clin Respir J. doi: 10.1111/crj.12196 Google Scholar
  28. 28.
    Galioto NJ, Danley DL, Van Maanen RJ (2011) Recurrent venous thromboembolism. Am Fam Phys 83(3):293–300Google Scholar
  29. 29.
    Verhovsek M, Douketis JD, Yi Q, Shrivastava S, Tait RC, Baglin T, Poli D, Lim W (2008) Systematic review: D-dimer to predict recurrent disease after stopping anticoagulant therapy for unprovoked venous thromboembolism. Ann Intern Med 149(7):481–490CrossRefPubMedGoogle Scholar
  30. 30.
    Prandoni P, Lensing AW, Prins MH, Bernardi E, Marchiori A, Bagatella P, Frulla M, Mosena L, Tormene D, Piccioli A (2002) Residual venous thrombosis as a predictive factor of recurrent venous thromboembolism. Ann Intern Med 137(12):955–960CrossRefPubMedGoogle Scholar
  31. 31.
    Cosmi B, Legnani C, Iorio A, Pengo V, Ghirarduzzi A, Testa S, Poli D, Tripodi A, Palareti G, Investigators P (2010) Residual venous obstruction, alone and in combination with D-dimer, as a risk factor for recurrence after anticoagulation withdrawal following a first idiopathic deep vein thrombosis in the prolong study. Eur J Vasc Endovasc Surg 39(3):356–365CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  1. 1.Department of Pulmonary DiseasesAtaturk University School of MedicineErzurumTurkey
  2. 2.Department of Pulmonary DiseaseAtaturk University School of MedicineErzurumTurkey

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