Predictive Effect of Mean Platelet Volume in Patients with Portal Vein Thrombosis: A Meta-analysis of Case-control Studies

Abstract

Mean platelet volume (MPV) is an early marker of platelet activation. Larger platelets, compared to small ones, increase platelet adhesion and aggregation, and present a higher thrombotic activity. Some studies have explored the association between MPV and the morbidity of portal vein thrombosis (PVT). The aim of this study was to evaluate the predictive effect of MPV in patients with PVT by a meta-analysis. We searched Pubmed, Web of Science, SCOPUS, OVID, CNKI and CBMD from database inception to September 13,2017. Seven studies in accordance with selection criteria were included. The extraction of basic data was independently conducted by two reviewers. The mean difference in MPV between PVT patients and controls were pooled with weighted mean difference (WMD) and 95% confidence interval of 0.88 fl (95% CI: 0.61-1.15). A random-effect model was chosen for an obvious heterogeneity in the pooling (Chi-square=27.12, df=6, P<000l, I²=77.9%). The sources of heterogeneity were from the difference of primary disease of participants and portal vein diameter. Taken together, our results reveal that MPV is a predictive indicator in patients with PVT.

Keywords

portal vein thrombosis / mean platelet volume / prediction / risk factors / metaanalysis

References

[1] QiX, HanG, FanD. Management of portal vein thrombosis in liver cirrhosis. Nat Rev Gastroenterol Hepatol, 2014, 11(7): 435-446

[2] ParikhS, ShahR, KapoorP. Portal vein thrombosis. Am J Med, 2010, 123(2): 111-119

[3] MaruyamaH, OkugawaH, TakahashiM, et al.. De novo portal vein thrombosis in virus-related cirrhosis: predictive factors and long-term outcomes. Am J Gastroenterol, 2013, 108(4): 568-574

[4] ZoccoMA, Di StasioE, De CristofaroR, et al.. Thrombotic risk factors in patients with liver cirrhosis: correlation with MELD scoring system and portal vein thrombosis development. J Hepatol, 2009, 51(4): 682-689

[5] FrancozC, BelghitiJ, VilgrainV, et al.. Splanchnic vein thrombosis in candidates for liver transplantation: usefulness of screening and anticoagulation. Gut, 2005, 54(5): 691-697

[6] AmitranoL, GuardascioneMA, BrancaccioV, et al.. Risk factors and clinical presentation of portal vein thrombosis in patients with liver cirrhosis. J Hepatol, 2004, 40(5): 736-741

[7] CaginYF, AtayanY, ErdoganMA, et al.. Incidence and clinical presentation of portal vein thrombosis in cirrhotic patients. Hepatobiliary Pancreat Dis Int, 2016, 15(5): 499-503

[8] FujiyamaS, SaitohS, KawamuraY, et al.. Portal vein thrombosis in liver cirrhosis: incidence, management, and outcome. BMC Gastroenterol, 2017, 17(1): 112

[9] QiX, ChenH, HanG. Effect of antithrombin, protein C and protein S on portal vein thrombosis in liver cirrhosis: a meta-analysis. Am J Med Sei, 2013, 346(1): 38-44

[10] PellicelliAM, D’AmbrosioC, BarbaraG, et al.. Clinical and Genetic factors associated to development of portal vein thrombosis in cirrhotic patients without hepatocellular carcinoma. J Hepatol, 2011, 54: S77

[11] MangiaA, VillaniMR, CappucciG, et al.. Causes of portal venous thrombosis in cirrhotic patients: the role of genetic and acquired factors. Eur J Gastroenterol Hepatol, 2005, 17(7): 745-51

[12] ColkesenY, MuderrisogluH. The role of mean platelet volume in predicting thrombotic events. Clin Chem Lab Med, 2012, 50(4): 631-634

[13] BathPM, ButterworthRJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis, 1996, 7(2): 157-161

[14] JakubowskiJA, AdlerB, ThompsonCB, et al.. Influence of platelet volume on the ability of prostacyclin to inhibit platelet aggregation and the release reaction. J Lab Clin Med, 1985, 105(2): 271-276

[15] ThompsonCB, JakubowskiJA, QuinnPG, et al.. Platelet size as a determinant of platelet function. J Lab Clin Med, 1983, 101(2): 205-213

[16] BathPM. The routine measurement of platelet size using sodium citrate alone as the anticoagulant. Thromb Haemost, 1993, 70(4): 687-690

[17] CeminR, DonazzanL, LippiG, et al.. Blood cells characteristics as determinants of acute myocardial infarction. Clin Chem Lab Med, 2011, 49(7): 1231-1236

[18] ZandeckiM, GenevieveF, GerardJ, et al.. Spurious counts and spurious results on haematology analysers: a review. Part I: platelets. Int J Lab Hematol, 2007, 29(1): 4-20

[19] Kilicli-CamurN, DemirtuncR, KonuralpC, et al.. Could mean platelet volume be a predictive marker for acute myocardial infarction?. Med Sei Monit, 2005Cr387-392

[20] GreiseneggerS, EndlerG, HsiehK, et al.. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events. Stroke, 2004, 35(7): 1688-1691

[21] PizzulliL, YangA, MartinJF, et al.. Changes in platelet size and count in unstable angina compared to stable angina or non-cardiac chest pain. Eur Heart J, 1998, 9(1): 80-84

[22] MoherD, LiberatiA, TetzlaffJ, et al.. Preferred reporting items for systematic reviews and metaanalyses: the PRISMA statement. Int J Surg, 2010, 8(5): 336-341

[23] AliosmanogluI, GuiM, OguzA, et al.. Can mean platelet volume be a new risk factor in portal venous thrombosis?. Clin Appl Thromb Hemost, 2013, 19(4): 433-436

[24] Abdel-RazikA, MousaN, ElhelalyR, et al.. De-novo portal vein thrombosis in liver cirrhosis: risk factors and correlation with the model for end-stage liver disease scoring system. Eur J Gastroenterol Hepatol, 2015, 27(5): 585-592

[25] QianYY, LiK. The early prevention and treatment of PVST after laparoscopic splenectomy: A prospective cohort study of 130 patients. Int J Surg, 2017, 44: 147-151

[26] GirleanuI, TrifanA, CojocariuC, et al.. Platelet indices in patients with de novo portal vein thrombosis and liver cirrhosis. Rev Med Chir Soc Med Nat Iasi, 2013, 117(3): 641-647

[27] HeS, HeF. Predictive model of portal venous system thrombosis in cirrhotic portal hypertensive patients after splenectomy. Int J Clin Exp Med, 2015, 8(3): 4236-4242

[28] HeS, FanX, ShiX, et al.. Risk factors for portal vein thrombosis after splenectomy for portal hypertension due to liver cirrhosis and establishment of its prediction model. Chin J General Surg (Chinese), 2016, 25(12): 1766-1772

[29] ZhangQ, GuoLY. Analysis of risk factors for portal vein thrombosis in cirrhosis. Med Philosop (Chinese), 2015, 12: 32-34

[30] HigginsJPT, GreenS. Cochrane Handbook for Systematic Reviews of Interventions. The Cochrane Collaboration, 2011

[31] Dickson BC.. Virchow’s triad. Br J Haematol, 2009, 145(3): 433

[32] BeyazitY, SayilirA, TorunS, et al.. Mean platelet volume as an indicator of disease severity in patients with acute pancreatitis. Clin Res Hepatol Gastroenterol, 2012, 36(2): 162-168

[33] GasparyanAY, AyvazyanL, MikhailidisDP, et al.. Mean platelet volume: a link between thrombosis and inflammation. Curr Pharm Des, 2011, 17(1): 47-58

[34] GroveEL, HvasAM, MortensenSB, et al.. Effect of platelet turnover on whole blood platelet aggregation in patients with coronary artery disease. J Thromb Haemost, 2011, 9(1): 185-191

[35] QiX, De StefanoV, LiH, et al.. Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis: a systematic review and meta-analysis of observational studies. Eur J Intern Med, 2015, 26(1): 23-29

[36] AmitranoL, GuardascioneMA, MenchiseA, et al.. Safety and efficacy of anticoagulation therapy with low molecular weight heparin for portal vein thrombosis in patients with liver cirrhosis. J Clin Gastroenterol, 2010, 44(6): 448-451

[37] SenzoloM, FerronatoC, BurraP. Anticoagulation for portal vein thrombosis in cirrhotic patients should be always considered. Intern Emerg Med, 2009, 4(2): 161-162

[38] CaoX, XieX, ZhouJ, et al.. Increased platelet volume in a general population with prehypertension: a cross-sectional study of 80545 participants from China. Hypertens Res, 2012, 35(9): 903-908

[39] NtaiosG, GurerO, FaouziM, et al.. Hypertension is an independent predictor of mean platelet volume in patients with acute ischaemic stroke. Intern Med J, 2011, 41(9): 691-695

[40] NadarSK, BlannAD, KamathS, et al.. Platelet indexes in relation to target organ damage in highrisk hypertensive patients: a substudy of the Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT). J Am Coll Cardiol, 2004, 44(2): 415-422

[41] TetikogluM, AktasS, SagdikHM, et al.. Mean Platelet Volume is Associated with Diabetic Macular Edema in Patients with Type-2 Diabetes Mellitus. Semin Ophthalmol, 2017, 32(5): 651-654

[42] ShahB, ShaD, XieD, et al.. The relationship between diabetes, metabolic syndrome, and platelet activity as measured by mean platelet volume: the National Health And Nutrition Examination Survey, 1999–2004. Diabetes Care, 2012, 35(5): 1074-1078