What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Heart failure. Intervention: Mean platelet volume (MPV) vs. Lower MPV or unaffected subjects. Primary outcome: Mortality and morbidity (OR 1.71, 95% CI 1.5-1.91).

January 1, 2025American Journal of Blood Research1 citationsOpen Access

Prognostic value of platelet volume indices in heart failure: a systematic review and meta-analysis

AAAmir Parsa AbhariIsfahan University of Medical Sciences

Key Result

Elevated mean platelet volume is a significant prognostic marker in heart failure, associated with increased mortality and morbidity with a pooled odds ratio of 1.71.

Study Design

Type

Meta-Analysis

Structured PICO

Do mean platelet volume (MPV) and platelet distribution width (PDW) predict mortality and morbidity in patients with heart failure?

Population

A systematic review and meta-analysis of 21 studies assessing the prognostic value of mean platelet volume and platelet distribution width for mortality and morbidity in patients with heart failure.

Exposure

Higher mean platelet volume (MPV) and platelet distribution width (PDW) as prognostic biomarkers

Comparator

Lower MPV/PDW values or unaffected subjects

Outcome

Mortality and morbidity (including all-cause and cardiovascular mortality, rehospitalization, extended hospital stay, pulmonary hypertension, atrial fibrillation, developing renal disease, and decreased functional capacity)hard clinical

Mean platelet volume (MPV) is a useful prognostic marker in heart failure associated with increased mortality and morbidity, whereas the prognostic significance of platelet distribution width (PDW) remains unclear.

Main Result

Odds Ratio: 1.71 (95% CI 1.5–1.91)

Limitations

Limited number of studies, especially regarding platelet distribution width (PDW)
Inadequate description of demographic and clinical data in some included studies, limiting meta-regression analyses
Use of random-effects model over a multilevel approach
Inclusion of studies with heterogeneous outcomes and populations, which may introduce bias
Majority of the included studies had not provided the intended demographic and clinical data
Heterogeneous outcomes across studies

Abstract

Objectives: Heart failure (HF) is a complex condition with a substantial global prevalence and clinical burden.Prognostic biomarkers are essential for effective management.This study systematically reviews and synthesizes the prognostic value of mean platelet volume (MPV) and platelet distribution width (PDW) in HF patients.Methods: A comprehensive search was conducted in Medline, Scopus, Web of Science, and Embase databases.Eligible studies were identified, screened, and selected according to pre-defined criteria.Data extraction and quality assessment were performed by independent reviewers.Meta-analyses were conducted using random-effects models, and heterogeneity was assessed using I 2 statistics.Publication bias was assessed using Egger's regression and Begg's tests.Results: From 12471 records, 21 studies were included.MPV showed significant predictive value, with pooled hazard ratios (HR) of 1.49 (0.67-3.32) and odds ratios (OR) of 1.71 (1.5-1.91) for mortality and morbidity.The pooled mean difference in MPV values between the affected and unaffected subjects was 0.66 (0.21-1.1, P=0.008).MPV was positively correlated with NT-proBNP levels (pooled coefficient: 0.13, P=0.028).The pooled area under the curve for MPV in prognosticating adverse outcomes was 0.75 (0.69-0.82).However, PDW did not show significant prognostic value (HR: 1.56, OR: 1.11).Conclusions: MPV is a useful prognostic marker in HF, associated with increased mortality and morbidity.Prognostic significance of PDW remains unclear, requiring additional research.The application of MPV can improve risk stratification and management of HF, but further research with larger populations and diverse settings is essential to confirm these findings and establish clinical reference ranges.

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