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Value of serial platelet indices measurements for the prediction of pulmonary embolism in patients with deep venous thrombosis.

Sevuk U, Bahadir MV, Altindag R, Baysal E, Yaylak B, Ay N, Ayaz F, Demirtas E - Ther Clin Risk Manag (2015)

Bottom Line: Receiver operating characteristics analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (area under the curve, 0.80), and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (area under the curve, 0.84) for prediction of PE occurrence in patients with DVT.PDW and MPV levels at the time of PE diagnosis were found to be independent risk factors for the occurrence of PE in patients with DVT.Serial measurements of MPV and PDW, and percent change in MPV and PDW appears to be a useful marker for predicting occurrence of acute PE in patients with a first episode of acute proximal DVT.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

ABSTRACT

Background: To date, no validated biomarkers with high sensitivity and specificity have been established for diagnosis of pulmonary embolism (PE) in patients with deep venous thrombosis (DVT). There is a need to develop simple and reliable noninvasive tests that can accurately identify patients with PE, even in small hospitals or clinics. The aim of this study was to investigate the value of mean platelet volume (MPV) and platelet distribution width (PDW) for predicting occurrence of PE in patients with DVT.

Methods: Records of acute DVT patients were reviewed retrospectively. Group 1 consisted of 50 patients with acute DVT and group 2 consisted of 50 patients with acute DVT who developed PE during follow-up. The control group consisted of patients with uncomplicated primary varicose veins of the lower limbs. Venous peripheral blood samples for measurement of MPV, PDW, and platelet count were drawn on admission, before the treatment, and at the time of PE diagnosis.

Results: MPV and PDW levels at the time of PE diagnosis were higher in group 2 than group 1 (P<0.001 and P=0.026, respectively). Receiver operating characteristics analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (area under the curve, 0.80), and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (area under the curve, 0.84) for prediction of PE occurrence in patients with DVT. PDW and MPV levels at the time of PE diagnosis were found to be independent risk factors for the occurrence of PE in patients with DVT.

Conclusion: Serial measurements of MPV and PDW, and percent change in MPV and PDW appears to be a useful marker for predicting occurrence of acute PE in patients with a first episode of acute proximal DVT.

No MeSH data available.


Related in: MedlinePlus

The ROC curve of Δ%MPV for the detection of pulmonary embolism in patients with deep vein thrombosis.Abbreviations: ROC, receiver operating characteristics; Δ%MPV, percent change for mean platelet volume levels.
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f1-tcrm-11-1243: The ROC curve of Δ%MPV for the detection of pulmonary embolism in patients with deep vein thrombosis.Abbreviations: ROC, receiver operating characteristics; Δ%MPV, percent change for mean platelet volume levels.

Mentions: A comparison of platelet indices and percent changes in platelet indices between groups is shown in Table 2. On admission, MPV and PDW levels were significantly higher in group 1 and group 2 than in the control group (P=0.002 and P<0.001 respectively). There was no significant difference in admission MPV (P=0.86) and PDW levels (P=0.8) between group 1 and group 2. MPV (P<0.001) and PDW (P<0.001) levels at the time of PE diagnosis were significantly higher in group 2 than in group 1 and the control group. Percent change for MPV levels (Δ%MPV) and percent change for PDW levels (Δ%PDW) were significantly higher in group 2 than in group 1 and the control group (P<0.001) (Table 2). There was a strong negative correlation between PC and MPV (ρ: −0.66; P<0.001) and a weak negative correlation between PC and PDW (ρ: −0.23; P=0.004). Logistic regression analysis showed that PDW levels at the time of PE diagnosis (odds ratio [OR], 1.3; 95% confidence interval [CI] =1.008–1.7; P=0.04) and MPV levels at the time of PE diagnosis (OR, 1.4; 95% CI =1.007–1.9; P=0.04) were independent risk factors for the occurrence of PE in patients with DVT after adjustment for age, sex, smoking status, BMI, and WBC. PDW (OR, 0.88; 95% CI =1.008–1.7; P=0.43) and MPV (OR, 0.91; 95% CI =0.64–1.3; P=0.62) levels on admission were not risk factors for the occurrence of PE. ROC analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (AUC, 0.80; 95% CI =0.71–0.89; PPV, 79.5%; NPV, 84%; P<0.001) and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (AUC, 0.84; 95% CI =0.78–0.91; PPV, 92%; NPV, 86.5%; P<0.001) for prediction of development of PE in patients with DVT. The ROC curves of Δ%MPV and Δ%PDW are shown in Figures 1 and 2 respectively.


Value of serial platelet indices measurements for the prediction of pulmonary embolism in patients with deep venous thrombosis.

Sevuk U, Bahadir MV, Altindag R, Baysal E, Yaylak B, Ay N, Ayaz F, Demirtas E - Ther Clin Risk Manag (2015)

The ROC curve of Δ%MPV for the detection of pulmonary embolism in patients with deep vein thrombosis.Abbreviations: ROC, receiver operating characteristics; Δ%MPV, percent change for mean platelet volume levels.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4548763&req=5

f1-tcrm-11-1243: The ROC curve of Δ%MPV for the detection of pulmonary embolism in patients with deep vein thrombosis.Abbreviations: ROC, receiver operating characteristics; Δ%MPV, percent change for mean platelet volume levels.
Mentions: A comparison of platelet indices and percent changes in platelet indices between groups is shown in Table 2. On admission, MPV and PDW levels were significantly higher in group 1 and group 2 than in the control group (P=0.002 and P<0.001 respectively). There was no significant difference in admission MPV (P=0.86) and PDW levels (P=0.8) between group 1 and group 2. MPV (P<0.001) and PDW (P<0.001) levels at the time of PE diagnosis were significantly higher in group 2 than in group 1 and the control group. Percent change for MPV levels (Δ%MPV) and percent change for PDW levels (Δ%PDW) were significantly higher in group 2 than in group 1 and the control group (P<0.001) (Table 2). There was a strong negative correlation between PC and MPV (ρ: −0.66; P<0.001) and a weak negative correlation between PC and PDW (ρ: −0.23; P=0.004). Logistic regression analysis showed that PDW levels at the time of PE diagnosis (odds ratio [OR], 1.3; 95% confidence interval [CI] =1.008–1.7; P=0.04) and MPV levels at the time of PE diagnosis (OR, 1.4; 95% CI =1.007–1.9; P=0.04) were independent risk factors for the occurrence of PE in patients with DVT after adjustment for age, sex, smoking status, BMI, and WBC. PDW (OR, 0.88; 95% CI =1.008–1.7; P=0.43) and MPV (OR, 0.91; 95% CI =0.64–1.3; P=0.62) levels on admission were not risk factors for the occurrence of PE. ROC analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (AUC, 0.80; 95% CI =0.71–0.89; PPV, 79.5%; NPV, 84%; P<0.001) and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (AUC, 0.84; 95% CI =0.78–0.91; PPV, 92%; NPV, 86.5%; P<0.001) for prediction of development of PE in patients with DVT. The ROC curves of Δ%MPV and Δ%PDW are shown in Figures 1 and 2 respectively.

Bottom Line: Receiver operating characteristics analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (area under the curve, 0.80), and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (area under the curve, 0.84) for prediction of PE occurrence in patients with DVT.PDW and MPV levels at the time of PE diagnosis were found to be independent risk factors for the occurrence of PE in patients with DVT.Serial measurements of MPV and PDW, and percent change in MPV and PDW appears to be a useful marker for predicting occurrence of acute PE in patients with a first episode of acute proximal DVT.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Surgery, Diyarbakir Gazi Yasargil Education and Research Hospital, Diyarbakir, Turkey.

ABSTRACT

Background: To date, no validated biomarkers with high sensitivity and specificity have been established for diagnosis of pulmonary embolism (PE) in patients with deep venous thrombosis (DVT). There is a need to develop simple and reliable noninvasive tests that can accurately identify patients with PE, even in small hospitals or clinics. The aim of this study was to investigate the value of mean platelet volume (MPV) and platelet distribution width (PDW) for predicting occurrence of PE in patients with DVT.

Methods: Records of acute DVT patients were reviewed retrospectively. Group 1 consisted of 50 patients with acute DVT and group 2 consisted of 50 patients with acute DVT who developed PE during follow-up. The control group consisted of patients with uncomplicated primary varicose veins of the lower limbs. Venous peripheral blood samples for measurement of MPV, PDW, and platelet count were drawn on admission, before the treatment, and at the time of PE diagnosis.

Results: MPV and PDW levels at the time of PE diagnosis were higher in group 2 than group 1 (P<0.001 and P=0.026, respectively). Receiver operating characteristics analysis revealed that a 5.2% increase in admission PDW during follow-up provided 70% sensitivity and 82% specificity (area under the curve, 0.80), and a 6.6% increase in admission MPV during follow-up provided 74% sensitivity and 83% specificity (area under the curve, 0.84) for prediction of PE occurrence in patients with DVT. PDW and MPV levels at the time of PE diagnosis were found to be independent risk factors for the occurrence of PE in patients with DVT.

Conclusion: Serial measurements of MPV and PDW, and percent change in MPV and PDW appears to be a useful marker for predicting occurrence of acute PE in patients with a first episode of acute proximal DVT.

No MeSH data available.


Related in: MedlinePlus