Mean platelet volume and mean platelet volume/platelet count ratio as a risk stratification tool in the assessment of severity of acute ischemic stroke

Abstract

The mean platelet volume (MPV) is a laboratory marker associated with platelet function and activity. Increased MPV in thromboembolic disease is reflected as an important risk factor. The aim of this study was to compare the MPV and mean platelet volume/platelet count (MPV/PC) ratio between ischemic cerebrovascular stroke and control subjects and furthermore, to find out their diagnostic value in an acute setting to help risk stratification in patients with ischemic stroke.
Methods: The cross-sectional study was conducted in Kuwait city Medical Hospitals, the state of Kuwait from April 2015 to October 2015. It comprised 50 consecutive patients with acute ischemic stroke, and 20 healthy volunteers. Blood samples were taken to measure MPV and MPV/PC ratio. The Severity of ischemic stroke was assessed by the Modified Rankin scale.
Result: The ischemic stroke patients had significantly higher MPV and MPV/PC ratio compared to the control group (p= 0.001 and p= 0.017) respectively. The MPV value was higher and more significant (p= 0.011) in patients group with high Rankin scale (P3) in comparison with those with lower scores. Receiver operator characteristic analysis revealed that an MPV cutoff value of >8.1 femtoliters provided 68.0% sensitivity and 80.0% specificity. An MPV/PC cutoff value of >0.031 fl10^-4uL^-1 showed 70% sensitivity and 75% specificity. The area under the ROC curve for MPV and MPV/PC ratio was 0.789 and 0.701 respectively, which indicates the high discriminative value of MPV and MPV/PC ratio for predicting severe ischemic stroke based on Rankin score P3 from a mild stroke.
Conclusion: MPV and MPV/PC ratio could be considered meaningful laboratory markers for the risk of acute ischemic stroke.