European Journal of Internal Medicine 31 (2016) e15
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Letters to the Editor Mean platelet volume and cardiovascular risk factors Keywords: Blood platelets Coronary disease Mean platelet volume Platelet activation Risk factors
As a result, the defined relationship between higher MPV and some cardiovascular risk factors like female gender, diabetes mellitus, metabolic syndrome, serum triglyceride, hypertension and pre-hypertension in EGAT cohort may be originated from the standardization problems in the MPV measurement procedure.
Conflict of interest The authors declare that they have no conflict of interest.
Dear Editor,
References
We read with a great interest the article of Sansanayudh et al. about mean platelet volume (MPV) and cardiovascular risk factors [1]. They found that the higher MPV associated with some cardiovascular risk factors like female gender, diabetes mellitus, metabolic syndrome, serum triglyceride, hypertension and pre-hypertension in data of the Electricity Generating Authority of Thailand (EGAT) cohort. We would like to comment on this paper. Firstly, the authors suggested that MPV correlated with platelet function and activation. Nowadays, the gold standard of platelet function is turbidometric platelet aggregometry [2]. Several studies showed that platelet parameters including MPV did not correlate with turbidometric platelet aggregometry [3–5]. Currently, the platelet parameters are not defined as platelet function tests [2]. Secondly, Lance described the multiple drawbacks of preanalytical conditions and measuring techniques of MPV as a diagnostic marker for cardiovascular disease [6]. One of them is the measurement time of MPV from venipuncture. Lance et al. showed that optimal measurement time should be 120 min after venipuncture using ethylenediaminetetraacetic acid (EDTA) as an anticoagulant [7]. All blood samples for complete blood count in this study were collected in EDTA tubes and all samples were processed approximately 6–8 h after venipuncture. The reliability of MPV data might be affected negatively because of the difference of the MPV measurement time in this study. De Luca et al. performed a big population study was to investigate whether MPV was associated with platelet reactivity and the extent of coronary artery disease among 1016 consecutive diabetic patients [5]. Platelet reactivity was evaluated by turbidometric platelet aggregometry in diabetic patients in this study. On the contrary, they reported that MPV was not related to platelet reactivity and the prevalence and extent of coronary artery disease in diabetic patients.
[1] Sansanayudh N, Muntham D, Yamwong S, Sritara P, Akrawichien T, Thakkinstian A. The association between mean platelet volume and cardiovascular risk factors. Eur J Intern Med 2016;30:37–42. [2] Harrison, P. Platelet function testing. Leung LLK, ed. Wolters Kluver: 2016 UpToDate. Available at: http://www.uptodate.com/contents/platelet-function-testing. Accessed January 11, 2016. [3] Ho CH, Chan IH. The influence of time of storage, temperature of storage, platelet number in platelet-rich plasma, packed cell, mean platelet volume, hemoglobin concentration, age, and sex on platelet aggregation test. Ann Hematol 1995;71: 129–33. [4] Beyan C, Kaptan K, Ifran A. Platelet count, mean platelet volume, platelet distribution width, and plateletcrit do not correlate with optical platelet aggregation responses in healthy volunteers. J Thromb Thrombolysis 2006;22:161–4. [5] De Luca G, Verdoia M, Cassetti E, Schaffer A, Di Giovine G, Bertoni A, et al. Mean platelet volume is not associated with platelet reactivity and the extent of coronary artery disease in diabetic patients. Blood Coagul Fibrinolysis 2013;24:619–24. [6] Lancé MD, Sloep M, Henskens YM, Marcus MA. Mean platelet volume as a diagnostic marker for cardiovascular disease: drawbacks of preanalytical conditions and measuring techniques. Clin Appl Thromb Hemost 2012;18:561–8. [7] Lancé MD, van Oerle R, Henskens YM, Marcus MA. Do we need time adjusted mean platelet volume measurements? Lab Hematol 2010;16:28–31.
Cengiz Beyan Gulhane Military Medical Academy, Department of Hematology, Ankara, Turkey Corresponding author at: Gulhane Military Medical Academy, Department of Hematology, Etlik, 06018, Ankara, Turkey. Tel.: +90 312 304 4103. E-mail addresses:
[email protected],
[email protected]. Esin Beyan Kecioren Training and Research Hospital, Department of Internal Medicine, Ankara, Turkey
Abbreviations: EDTA, ethylenediaminetetraacetic acid; EGAT, Electricity Generating Authority of Thailand; MPV, mean platelet volume.
http://dx.doi.org/10.1016/j.ejim.2016.01.018 0953-6205/© 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
11 January 2016
