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      The association between mean platelet volume and inflammation in geriatric patients with emergency hypertension

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          Abstract

          Objectives

          We aimed to investigate the role of inflammation parameters and platelet activation in geriatric patients with hypertension. Therefore, we compared the levels of those parameters in patients with hypertensive urgency and emergency. We also investigated the potential relationship between those parameters.

          Methods

          Ninety-six hypertensive (HT) patients (aged > 60) were included in the study in two groups: HT emergency (N = 48, group 1) and HT urgency (N = 48, group 2). Mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (NLR) and high-sensitive C reactive protein (hs-CRP) were compared between those groups. Optimum cut-off levels of each parameter were determined by the use of Receiver operating characteristic (ROC) curve analysis. Pearson correlation test was used to examine the relationship between variables.

          Results

          The mean MPV and hs-CRP levels were significantly higher in patients with HT emergencies (both P < 0.001). Mean NLR was also significantly different between the two groups (P = 0.011). Pearson correlation analysis revealed a positive but weak correlation between the MPV and NLR (r = 0.245, P = 0.016), the hs-CRP level (r = 0.394, P < 0.001), and the WBC count (r = 0.362, P < 0.001).

          Conclusion

          Increased platelet activity and inflammation are associated with the end organ failure. Levels of MPV and other inflammatory parameters may be useful in the management of geriatric patients with HT.

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          Most cited references15

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          Mean platelet volume as an indicator of platelet activation: methodological issues.

          Yongsoon Park, Norberta Schoene, William Harris (2015)
          Mean platelet volume (MPV) is increased in patients at high risk for athero-thrombotic diseases. Thus, an elevated MPV may be a risk marker for platelet activation. Healthy subjects with normal triglyceride (TG) levels (90+/-6 mg/dl; n = 40) or mild hypertriglyceridemia (161+/-79 mg/dl; n = 32) were studied. MPV was measured in fasting blood samples before and after stimulation with collagen (10 micro g/ml), and exposure to 4 or 37 degrees C. Samples from the normotriglyceridemic subjects were tested again 4 h after consuming a high-fat drink. Collagen and exposure to 4 degrees C increased MPV, whereas incubation at 37 degrees C lowered MPV regardless of TG level. There was no significant difference in unstimulated MPV between the fasting and the fed states in the normotriglyceridemic subjects (both 7.2+/-0.1 fl; mean+/-SEM), nor between the latter group and hypertriglyceridemic subjects (7.0+/-0.1 fl). There was a significant negative relation between MPV and fasting TG level. This study suggests that MPV response to low-dose collagen may be a useful indicator of platelet propensity to activation. Further studies are warranted to correlate MPV with classical platelet aggregation tests and with the use of platelet-active drugs.
          Article 0 comments Cited 90 times – based on 0 reviews     Review now
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            Mean platelet volume and coronary artery disease: a systematic review and meta-analysis.

            Nakarin Sansanayudh, Thunyarat Anothaisintawee, Dittaphol Muntham … (2014)
            Platelets with high hemostatic activity play an important role in the pathophysiology of coronary artery disease(CAD) and mean platelet volume(MPV) has been proposed as an indicator of platelet reactivity. Thus, MPV may emerge as a potential marker of CAD risk. The aim of this study was to conduct a systematic review and meta-analysis comparing mean difference in MPV between patients with CAD and controls and pooling the odds ratio of CAD in those with high versus low MPV.
            Article 0 comments Cited 52 times – based on 0 reviews     Review now
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              Platelets as predictors of vascular risk: is there a practical index of platelet activity?

              Stavroula Tsiara, Moses S. Elisaf, I Jagroop … (2003)
              Activated platelets play a role in the pathogenesis of coronary heart disease (CHD). Following activation, platelets change shape, aggregate, and release several bioactive substances. The aim of this review is to identify if there is a simple and cost-effective method that indicates platelet activation and predicts the risk of CHD and vascular events. The rationale for identifying high-risk patients is to reduce their risk of vascular events by administering appropriate and effective antiplatelet treatment, like aspirin, clopidogrel, or combination regimens. Many laboratory tests estimating platelet activity have been described. Some are relatively simple, such as spontaneous or agonist-induced platelet aggregation. Other tests include measuring the mean platelet volume (MPV) or plasma soluble P-selectin levels. Some more complex tests include flow cytometry to determine platelet GP IIb/IIIa receptors, platelet surface P-selectin, platelet-monocyte aggregates, and microparticles. Only few prospective studies assessed the predictive value of platelet activation in healthy individuals. Although the MPV seems an 'easy' method, there are insufficient data supporting its ability to predict the risk of a vascular event in healthy adults. Platelet aggregation, in whole blood or in platelet-rich plasma was not consistently predictive of vascular risk. Soluble P-selectin measurement is a promising method but it needs further evaluation. Flow cytometry methods are costly, time-consuming, and need specialized equipment. Thus, they are unlikely to be useful in estimating the risk in large numbers of patients. There is as yet no ideal test for the detection of platelet activation. Each currently available test has merits and disadvantages. Simple methods such as the MPV and the determination of platelet release products need further evaluation.
              Article 0 comments Cited 52 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Mehmet Tahir Gokdemir
                Journal
                Journal ID (nlm-ta): Turk J Emerg Med
                Journal ID (iso-abbrev): Turk J Emerg Med
                Title: Turkish Journal of Emergency Medicine
                Publisher: Elsevier
                ISSN (Electronic): 2452-2473
                Publication date PMC-release: 28 March 2018
                Publication date Collection: January 2019
                Publication date (Electronic): 28 March 2018
                Volume: 19
                Issue: 1
                Pages: 16-20
                Affiliations
                [a ]Health Sciences University, Gazi Yasargil Research and Training Hospital, Emergency Department, Diyarbakir, Turkey
                [b ]Dicle University, School of Medicine, Department of Physiology, Diyarbakir, Turkey
                Author notes
                [∗ ]Corresponding author. m.gokdemir2@ 123456saglik.gov.tr
                Article
                Publisher ID: S2452-2473(18)30030-X
                DOI: 10.1016/j.tjem.2018.03.003
                PMC ID: 6370900
                PubMed ID: 30793060
                SO-VID: b9c86f3a-27bf-4973-ac06-c4230dcd064e
                Copyright © © 2018 The Emergency Medicine Association of Turkey. Production and hosting by Elsevier B.V. on behalf of the Owner.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 26 January 2018
                Date revision received : 10 March 2018
                Date accepted : 14 March 2018
                Categories
                Subject: Original Research Paper

                Keywords: hypertensive emergency,mean platelet volume,high-sensitive c reactive protein
                Data availability:
                Keywords: hypertensive emergency, mean platelet volume, high-sensitive c reactive protein

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