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Erschienen in: Lung 4/2017

15.06.2017

Predictive Value of Mean Platelet Volume for Pulmonary Embolism Recurrence

verfasst von: Omer Araz, Fadime Sultan Albez, Elif Yilmazel Ucar, Bugra Kerget, Nafiye Yılmaz, Metin Akgun

Erschienen in: Lung | Ausgabe 4/2017

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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.
Literatur
1.
Zurück zum Zitat Limbrey R, Howard L (2015) Developments in the management and treatment of pulmonary embolism. Eur Respir Rev 24(137):484–497CrossRefPubMed Limbrey R, Howard L (2015) Developments in the management and treatment of pulmonary embolism. Eur Respir Rev 24(137):484–497CrossRefPubMed
2.
Zurück zum Zitat 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):2276–2315CrossRefPubMed 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):2276–2315CrossRefPubMed
4.
Zurück zum Zitat Dow R (1994) The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci 15:12–15 Dow R (1994) The clinical and laboratory utility of platelet volume parameters. Aust J Med Sci 15:12–15
5.
Zurück zum Zitat Rowan R (1986) Platelet size distribution analysis: principles techniques and potential clinical utility. Hematol Rev 1:109–144 Rowan R (1986) Platelet size distribution analysis: principles techniques and potential clinical utility. Hematol Rev 1:109–144
6.
Zurück zum Zitat 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):381–385CrossRefPubMed 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):381–385CrossRefPubMed
7.
Zurück zum Zitat 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):1081–1086CrossRefPubMed 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):1081–1086CrossRefPubMed
8.
Zurück zum Zitat 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):214–221CrossRefPubMed 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):214–221CrossRefPubMed
9.
Zurück zum Zitat 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):1597–1602CrossRefPubMed 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):1597–1602CrossRefPubMed
10.
Zurück zum Zitat 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:d3036CrossRefPubMedPubMedCentral 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:d3036CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat 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):392–397CrossRefPubMed 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):392–397CrossRefPubMed
12.
Zurück zum Zitat 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):824–833CrossRefPubMed 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):824–833CrossRefPubMed
13.
Zurück zum Zitat 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:d813CrossRefPubMedPubMedCentral 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:d813CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat 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):1630–1636CrossRefPubMed 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):1630–1636CrossRefPubMed
15.
Zurück zum Zitat 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):517–523CrossRef 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):517–523CrossRef
16.
Zurück zum Zitat Connors JM (2013) Extended treatment of venous thromboembolism. N Engl J Med 368(8):767–769CrossRefPubMed Connors JM (2013) Extended treatment of venous thromboembolism. N Engl J Med 368(8):767–769CrossRefPubMed
17.
Zurück zum Zitat 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):709–718CrossRefPubMed 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):709–718CrossRefPubMed
18.
Zurück zum Zitat 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):699–708CrossRefPubMed 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):699–708CrossRefPubMed
19.
Zurück zum Zitat Tong M, Seth P, Penington D (1987) Proplatelets and stress platelets. Blood 69(2):522–528PubMed Tong M, Seth P, Penington D (1987) Proplatelets and stress platelets. Blood 69(2):522–528PubMed
20.
Zurück zum Zitat Thompson CB, Jakubowski JA (1988) The pathophysiology and clinical relevance of platelet heterogeneity. Blood 72(1):1–8PubMed Thompson CB, Jakubowski JA (1988) The pathophysiology and clinical relevance of platelet heterogeneity. Blood 72(1):1–8PubMed
21.
Zurück zum Zitat Bessman J, Gilmer P, Gardner F (1984) Use of mean platelet volume improves detection of platelet disorders. Blood cells 11(1):127–135 Bessman J, Gilmer P, Gardner F (1984) Use of mean platelet volume improves detection of platelet disorders. Blood cells 11(1):127–135
22.
Zurück zum Zitat 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):1919–1924CrossRefPubMed 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):1919–1924CrossRefPubMed
23.
Zurück zum Zitat Lindmarker P, Schulman S (2000) The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. J Intern Med 247(5):601–606CrossRefPubMed Lindmarker P, Schulman S (2000) The risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. J Intern Med 247(5):601–606CrossRefPubMed
24.
Zurück zum Zitat Bath P, Butterworth R (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinol 7(2):157–161CrossRef Bath P, Butterworth R (1996) Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinol 7(2):157–161CrossRef
25.
Zurück zum Zitat 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):443–460CrossRefPubMed 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):443–460CrossRefPubMed
26.
Zurück zum Zitat 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):553–560CrossRefPubMed 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):553–560CrossRefPubMed
27.
Zurück zum Zitat 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 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
28.
Zurück zum Zitat Galioto NJ, Danley DL, Van Maanen RJ (2011) Recurrent venous thromboembolism. Am Fam Phys 83(3):293–300 Galioto NJ, Danley DL, Van Maanen RJ (2011) Recurrent venous thromboembolism. Am Fam Phys 83(3):293–300
29.
Zurück zum Zitat 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):481–490CrossRefPubMed 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):481–490CrossRefPubMed
30.
Zurück zum Zitat 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):955–960CrossRefPubMed 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):955–960CrossRefPubMed
31.
Zurück zum Zitat 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):356–365CrossRefPubMed 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):356–365CrossRefPubMed
Metadaten
Titel
Predictive Value of Mean Platelet Volume for Pulmonary Embolism Recurrence
verfasst von
Omer Araz
Fadime Sultan Albez
Elif Yilmazel Ucar
Bugra Kerget
Nafiye Yılmaz
Metin Akgun
Publikationsdatum
15.06.2017
Verlag
Springer US
Erschienen in
Lung / Ausgabe 4/2017
Print ISSN: 0341-2040
Elektronische ISSN: 1432-1750
DOI
https://doi.org/10.1007/s00408-017-0020-7

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