Association between mean platelet volume and pulmonary embolism: a systematic review and meta-analysis.
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ABSTRACT:
SUBMITTER: Lin W
PROVIDER: S-EPMC8312463 | biostudies-literature | 2021 Jul
REPOSITORIES: biostudies-literature
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Association between mean platelet volume and pulmonary embolism: a systematic review and meta-analysis.
Lin Wenyi W Wu Yu Y Lu Xuan X Hu Yu Y
Aging 20210702 13
Platelet activation plays an important role in the progression of pulmonary embolism (PE). Mean platelet volume (MPV) can serve as a marker of platelet activity in patients with PE. Many studies have reported different results regarding the relationship. Therefore, we aimed to perform a systematic review and meta-analysis to evaluate the relationship between MPV and PE. Two reviewers independently searched relevant articles in databases from inception to April 21, 2021 and identified all studies ...[more]
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Project description:BackgroundAcute pulmonary embolism (PE) is the third most fatal cardiovascular disease. PE is frequently misdiagnosed due to its clinical presentation's heterogeneity and the inexistence of biomarkers for its immediate diagnosis. Mean platelet volume (MPV) has shown a potential role as a biomarker in acute PE. In this analysis, we aimed to systematically compare the MPV in patients with and without definite diagnosis of PE, in emergency departments.MethodsEmbase, PubMed and Medline were searched for relevant publications, in English. The main inclusion criteria were studies which compared MPV in patients with acute PEA versus a control group.ResultsThirteen studies consisting of a total number of 2428 participants were included. Of the participants included, 1316 were patients with confirmed acute PE, and 1112 were assigned to the control group. MPV was significantly higher in patients with acute PE than in controls (RR: 0.84, 95% CI: 0.76 - 0.92; P < .00001). There was a significant heterogeneity in the data.ConclusionsThis analysis showed higher MPV to be associated with acute PE immediate diagnosis. These data show promise for the use of MPV as a readily available biomarker for the diagnosis of acute PE at the emergency department.
| S-EPMC7549176 | biostudies-literature
Project description:BackgroundPreeclampsia (PE) is a pregnancy-specific disorder characterized by endothelial dysfunction, and activation of the coagulation system. Alteration of PLT parameters is the common hematological abnormality observed in women with PE. The main aim of this study was to systematically review previous studies from around the world to generate evidence about the relationship between platelet count (PC) and PE, as well as mean platelet volume (MPV) and PE, by calculating the pooled weighted mean difference (WMD) of PC and MPV between PE and normotensive (NT) groups.MethodsRelevant articles which were published in the English language from January 10, 2011, to January 10, 2021, were systematically searched through PubMed, Web of Science, and African journals online. In addition, reference probing of published articles searching was employed through Google Scholar and Google for searching grey literature. The methodological qualities of articles were assessed using Joana Brigg's institute critical appraisal checklist. A random-effects model was used to estimate pooled WMD of PLT parameters between the two groups with the respective 95% confidence intervals (CI) using Stata version 11.0. The I2 statistics and Egger's regression test were used to assess heterogeneity and publication bias among included studies, respectively.ResultsA total of 25 articles were included in this systematic review and meta-analysis. Of which, 23 studies were used in each PC and MPV analysis. The overall pooled WMD of PC and MPV between PE and NT groups were -41.45 × 109/L [95% CI; -51.8, -31.0] and 0.98 fl [95% CI; 0.8, 1.1], respectively. The pooled WMD revealed that PC decreased significantly in the PE group compared to the NT group while MPV increased significantly in the PE group.ConclusionsThis systematic review and meta-analysis indicated that there is a significant decrease in PC and a significant increase in MPV during PE development among pregnant women. As a result, a change in these parameters among pregnant women may indicate the development of PE.
| S-EPMC9473393 | biostudies-literature
Project description:BackgroundDespite polysomnography (PSG) being acknowledged being considered the gold standard for diagnosing obstructive sleep apnea-hypopnea syndrome (OSAHS), researchers have been seeking a biomarker that is less invasive, more practical in detection, and cost-effective for diagnosing and assessing the severity of the disease. To address this concern, the values of mean platelet volume (MPV) between patients with OSAHS and healthy controls were compared, and the relationship between MPV and multiple sleep monitoring parameters was analyzed in this study.MethodsA comprehensive search was conducted across medical databases, including PubMed, Web of Science, EMBASE, CNKI, and Wanfang, up until August 2, 2023, to identify published articles related to OSAHS. This study reviewed the literature regarding the values of MPV in individuals with OSAHS and control groups, the Pearson/Spearman correlation coefficients between MPV and sleep monitoring parameters, and the odds ratios (OR) of MPV concerning the occurrence of cardiovascular diseases (CVDs) in patients with OSAHS. Meta-analyses were performed using standardized mean difference (SMD), Fisher's z values correlation coefficients (ZCOR) and odds ratio (OR) as effect variables. A fixed-effect model was used if the heterogeneity was not significant (I2<50%); otherwise, a random-effect model was applied. We will also combine the treatment effect estimates of individual trials using fixed-effect and random-effects models. Statistical analysis was carried out by employing STATA 11.0 and R 4.1.3.ResultsIn total, 31 articles were selected for the final analysis. The study involved 3604 patients and 1165 control individuals. The MPV in the OSAHS group was considerably elevated in comparison to the healthy controls (SMD = 0.37, 95%CI = 0.21-0.53, P < 0.001), particularly among individuals with severe OSAHS (SMD = 0.57, 95%CI = 0.23-0.90, P = 0.001). Subgroup analysis based on ethnicity, mean body mass index (BMI), and study design type also revealed a considerably higher MPV in the OSAHS category in comparison to the healthy controls. Furthermore, MPV showed correlations with various sleep monitoring parameters. The elevation of MPV may be one of the risk factors for CVDs in individuals with OSAHS (adjusted OR = 1.72, 95%CI = 1.08-2.73, P = 0.022).ConclusionMPV is a relatively simple, cost-effective, and practical indicator of the severity of OSAHS, with its values being linked to the risk of CVDs in individuals with OSAHS.
| S-EPMC10871486 | biostudies-literature
Project description:BackgroundInflammatory bowel disease (IBD) is a chronic gastrointestinal tract inflammatory state, which is affecting millions of individuals in the world. It can affect alimentary canals such as colon, rectum, ileum and other parts. In IBD, platelet parameters underwent several changes. Therefore, the aim of this review was determining the estimated pooled mean platelet volume and mean difference in inflammatory bowel disease to elucidate its potential diagnostic value.MethodsArticles were extensively searched in bibliographic databases using Medical Subject Heading and entry phrases or terms. In addition, articles were directly searched in Google Scholar to account for the studies omission in searching bibliographic databases. Observational (cohort, cross-sectional and case-control) studies, published in English language and conducted on IBD were included. For studies meeting the eligibility criteria, the first author's name, publication year, population, study design, study area, sample size, mean platelet volume and standard deviation were extracted and entered in to Microsoft-excel. The analysis was done by Stata version 11. In order to estimate the pooled mean platelet volume and mean difference, random effect model was done. The heterogeneity was quantified using Higgin's I2 statistics. Publication bias was determined using Egger's test statistics and funnel plot. Sub-group analysis based on population carried to reduce heterogeneity.ResultsA total of 17 relevant articles with 2957 participants (1823 IBD cases and 1134 healthy controls) were included to this study. The pooled estimated MPV was 9.29fl; 95% CI: 9.01-9.57 and 9.50fl; 95% CI: 8.81-10.20 in IBD and control groups, respectively. The standardized pooled estimate of mean difference in mean platelet volume was -0.83fl; 95% CI: -1.15, -0.51; I2: 93.1%; P-value < 0.001. In subgroup analysis based on population, the highest estimated mean difference in MPV was observed among patients of CD; -2.30; 95% CI: -3.46, -1.14; I2: 97.8%; P-value < 0.001.ConclusionAccording to the current systematic review and meta-analysis, mean platelet volume was lower in IBD compared to control. The decreased mean platelet volume could be attributed to platelet consumption or sequestration associated with the progression of IBD. As a result, in IBD, mean platelet volume can provide diagnostic and prognostic information.
| S-EPMC9426900 | biostudies-literature
Project description:BackgroundPre-eclampsia (PE) is a severe pregnancy complication. Thrombocytopenia and platelet dysfunction are common hematology disorders in PE. Previous studies considered mean platelet volume (MPV), a functional marker of platelets, as a potentially useful predictor for the diagnosis of PE.MethodsPubMed, China Biomedical Literature Database, Chinese National Knowledge Infrastructure, Embase, Wanfang, VIP, and Cochrane Library databases were searched to gather diagnostic trials evaluating the diagnosis of PE using MPV, from their inception to 13 March 2023. We also searched Google Scholar and Baidu.ResultsA total of 22 studies from 20 articles were found. The pooled diagnostic accuracy of the MPV for PE recognition was as follows: sensitivity (SEN) 0.676 [95% confidence interval (CI) (0.658-0.694)], specificity (SPE) 0.710 [95% CI (0.703-0.717)], and diagnostic odds ratio (DOR) 7.012 [95% CI (4.226-11.636)], and the SROC-AUC and Q* indices were 0.7889 and 0.7262, respectively. The pooled SEN, SPE, and DOR of the diagnostic accuracy of MPV for PE before 16 weeks of gestation were 0.707 [95% CI (0.670-0.743)], 0.639 [95% CI (0.611-0.667)], and 4.026 [95% CI (2.727-5.943)], and the SROC-AUC and Q* indices were 0.7278 and 0.6753, respectively. For the interval of truncation values between 9 and 10 fl, the SROC-AUC and Q* indices for MPV were 0.8856 and 0.8162, respectively.ConclusionsAvailable evidence suggests that MPV has a moderate predictive and diagnostic value for PE, particularly in diagnosing after 20 weeks of gestation. The diagnostic accuracy is higher when the MPV cut-off falls between 9 and 10 fl. The sensitivity of MPV alone in diagnosing PE is not high, and the combination of other markers for predictive diagnosis may better differentiate PE.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023425154, identifier: CRD42023425154.
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Project description:BackgroundThe impact of pulmonary embolism response teams (PERTs) on treatment choice and outcomes of patients with acute pulmonary embolism (PE) is still uncertain.ObjectiveTo determine the effect of PERTs in the management and outcomes of patients with PE.MethodsPubMed, Embase, Web of Science, CINAHL, WorldWideScience and MedRxiv were searched for original articles reporting PERT patient outcomes from 2009. Data were analysed using a random effects model.Results16 studies comprising 3827 PERT patients and 3967 controls met inclusion criteria. The PERT group had more patients with intermediate and high-risk PE (66.2%) compared to the control group (48.5%). Meta-analysis demonstrated an increased risk of catheter-directed interventions, systemic thrombolysis and surgical embolectomy (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.74-2.53; p<0.01), similar bleeding complications (OR 1.10, 95% CI 0.88-1.37) and decreased utilisation of inferior vena cava (IVC) filters (OR 0.71, 95% CI 0.58-0.88; p<0.01) in the PERT group. Furthermore, there was a nonsignificant trend towards decreased mortality (OR 0.87, 95% CI 0.71-1.07; p=0.19) with PERTs.ConclusionsThe PERT group showed an increased use of advanced therapies and a decreased utilisation of IVC filters. This was not associated with increased bleeding. Despite comprising more severe PE patients, there was a trend towards lower mortality in the PERT group.
| S-EPMC9724819 | biostudies-literature
Project description:Several genetic variants associated with platelet count and mean platelet volume (MPV) were recently reported in people of European ancestry. In this meta-analysis of 7 genome-wide association studies (GWAS) enrolling African Americans, our aim was to identify novel genetic variants associated with platelet count and MPV. For all cohorts, GWAS analysis was performed using additive models after adjusting for age, sex, and population stratification. For both platelet phenotypes, meta-analyses were conducted using inverse-variance weighted fixed-effect models. Platelet aggregation assays in whole blood were performed in the participants of the GeneSTAR cohort. Genetic variants in ten independent regions were associated with platelet count (N?=?16,388) with p<5×10(-8) of which 5 have not been associated with platelet count in previous GWAS. The novel genetic variants associated with platelet count were in the following regions (the most significant SNP, closest gene, and p-value): 6p22 (rs12526480, LRRC16A, p?=?9.1×10(-9)), 7q11 (rs13236689, CD36, p?=?2.8×10(-9)), 10q21 (rs7896518, JMJD1C, p?=?2.3×10(-12)), 11q13 (rs477895, BAD, p?=?4.9×10(-8)), and 20q13 (rs151361, SLMO2, p?=?9.4×10(-9)). Three of these loci (10q21, 11q13, and 20q13) were replicated in European Americans (N?=?14,909) and one (11q13) in Hispanic Americans (N?=?3,462). For MPV (N?=?4,531), genetic variants in 3 regions were significant at p<5×10(-8), two of which were also associated with platelet count. Previously reported regions that were also significant in this study were 6p21, 6q23, 7q22, 12q24, and 19p13 for platelet count and 7q22, 17q11, and 19p13 for MPV. The most significant SNP in 1 region was also associated with ADP-induced maximal platelet aggregation in whole blood (12q24). Thus through a meta-analysis of GWAS enrolling African Americans, we have identified 5 novel regions associated with platelet count of which 3 were replicated in other ethnic groups. In addition, we also found one region associated with platelet aggregation that may play a potential role in atherothrombosis.
| S-EPMC3299192 | biostudies-literature
Project description:To review the evidence for existing prognostic models in acute pulmonary embolism (PE) and determine how valid and useful they are for predicting patient outcomes.Systematic review and meta-analysis.OVID MEDLINE and EMBASE, and The Cochrane Library from inception to July 2014, and sources of grey literature.Studies aiming at constructing, validating, updating or studying the impact of prognostic models to predict all-cause death, PE-related death or venous thromboembolic events up to a 3-month follow-up in patients with an acute symptomatic PE.Study characteristics and study quality using prognostic criteria. Studies were selected and data extracted by 2 reviewers.Summary estimates (95% CI) for proportion of risk groups and event rates within risk groups, and accuracy.We included 71 studies (44,298 patients). Among them, 17 were model construction studies specific to PE prognosis. The most validated models were the PE Severity Index (PESI) and its simplified version (sPESI). The overall 30-day mortality rate was 2.3% (1.7% to 2.9%) in the low-risk group and 11.4% (9.9% to 13.1%) in the high-risk group for PESI (9 studies), and 1.5% (0.9% to 2.5%) in the low-risk group and 10.7% (8.8% to12.9%) in the high-risk group for sPESI (11 studies). PESI has proved clinically useful in an impact study. Shifting the cut-off or using novel and updated models specifically developed for normotensive PE improves the ability for identifying patients at lower risk for early death or adverse outcome (0.5-1%) and those at higher risk (up to 20-29% of event rate).We provide evidence-based information about the validity and utility of the existing prognostic models in acute PE that may be helpful for identifying patients at low risk. Novel models seem attractive for the high-risk normotensive PE but need to be externally validated then be assessed in impact studies.
| S-EPMC4854007 | biostudies-other
Project description:Background. An increase in the mean platelet volume (MPV) has been proposed as a novel prognostic indicator in critically ill patients. Objective. We conducted a systematic review and meta-analysis to determine whether there is an association between MPV and mortality in critically ill patients. Methods. We did electronic search in Medline, Scopus, and Embase up to November 2015. Results. Eleven observational studies, involving 3724 patients, were included. The values of initial MPV in nonsurvivors and survivors were not different, with the mean difference with 95% confident interval (95% CI) being 0.17 (95% CI: -0.04, 0.38; p = 0.112). However, after small sample studies were excluded in sensitivity analysis, the pooling mean difference of MPV was 0.32 (95% CI: 0.04, 0.60; p = 0.03). In addition, the MPV was observed to be significantly higher in nonsurvivor groups after the third day of admission. On the subgroup analysis, although patient types (sepsis or mixed ICU) and study type (prospective or retrospective study) did not show any significant difference between groups, the difference of MPV was significantly difference on the unit which had mortality up to 30%. Conclusions. Initial values of MPV might not be used as a prognostic marker of mortality in critically ill patients. Subsequent values of MPV after the 3rd day and the lower mortality rate unit might be useful. However, the heterogeneity between studies is high.
| S-EPMC4757676 | biostudies-literature
Project description:BackgroundThe incidence of acute pulmonary embolism (APE) (especially early diagnosis) has increased annually in recent years, but the diagnosis of APE is a great challenge for every clinician. However, few studies have evaluated multiple diagnostic indicators simultaneously.MethodsA systematic search was performed using CNKI, Wan fang data, VIP, PubMed and Web of Science for studies on the diagnosis of pulmonary embolism published up to October 31, 2022. Using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2), we evaluated the risk of bias in included studies, and used a random-effects meta-analysis to obtain the summary sensitivity and specificity. The data that were extracted and calculated for this study included the first author, year of publication, country, study type, sample size, disease type, gold standard, diagnostic indicators and 4-compartment table data. We strictly followed the Preferred Reporting Items for Systematics reviews and Meta-Analysis (PRISMA) guidelines in this review.ResultsThis study included 30 articles with a total sample size of 8947 cases, involving 4 detection methods: D-dimer, Geneva rules, Wells rules, and lung imaging. The combined effect size showed that lung imaging had the highest diagnostic value (SEN = 0.95, SPE = 0.89), followed by D-dimer (SEN = 0.92, SPE = 0.60), Geneva rules (SEN = 0.78, SPE = 0.68), and Wells rules (SEN = 0.77, SPE = 0.67). The area of lung imaging was largest under the Summary Receiver Operator Characteristic (SROC) curve (AUC = 0.97), followed by Geneva rules (AUC = 0.80), Wells rules (AUC = 0.79), and D-dimer (AUC = 0.74).ConclusionAll 4 detection methods showed good ability to diagnose PE, and lung imaging was the best. Clinical trials are recommended to build an early decision-making model for the diagnosis of pulmonary embolism in order to increase the detection rate and improve prognosis.
| S-EPMC10344512 | biostudies-literature