Association Between Mean Platelet Volume and Functional Outcome in Patients with Acute Ischemic Stroke: A Systematic Review with Meta-Analysis
Milagros Pascual-Guevara1, Miguel Cabanillas Lazo1, Claudia Cruzalegui Bazan1, Carlos Quispe1, Milenka Cierto2, Renzo Vallejos2, Joel Sequeiros Chirinos3, Carlos Alva-Diaz4
1Red de Eficacia Clínica y Sanitaria (REDECS), 2Universidad Nacional Mayor de San Marcos, 3UTHSC Department of Neurology, 4Universidad Señor de Sipán
Objective:
To conduct a systematic review with meta-analysis to summarize the current evidence on MPV as a potential biomarker for functional outcome in patients with acute ischemic stroke.
Background:
Evidence has shown an association between blood biomarkers, such as mean platelet volume (MPV), and the formation of thrombosis and embolisms.
Design/Methods:
A systematic search was conducted in PubMed, Embase, Scopus, Web of Science, and Google Scholar until December 2021. A meta-analysis was applied with a random effects model by the Paule-Mandel estimator. Likewise, a subgroup analysis was performed according to the treatment reveived by patients. Sensitivity analysis was performed using exclusion meta-analysis and the Dersimonian-Laird estimator. To identify the certainty of the evidence, the GRADE criteria for continuous outcomes were performed.
Results:
We selected 37 studies from our initial search. A meta-analysis of 9 studies (1707 patients) with moderate certainty of the evidence showed that higher MPV levels at hospital admission were predictor of poor functional outcome (modified Rankin Scale >2) at three months (Difference of means [DM]: 0.64; 95% CI: 0.33, 0.94; I2= 78%). An analysis by subgroups was performed according to the treatment administered and no statistically significant differences were found (Intravenous thrombolysis [DM]: 0.82; 95% CI: 0.22, 1.42; I2= 82%; Treatment not specified [DM]: 0.49; 95% CI: 0.20, 0.78; I2= 75%). Likewise, the sensitivity analysis did not weaken our results.
Conclusions:
With moderate certainty of the evidence, we found that MPV is useful as a prognostic biomarker in patients with acute ischemic stroke. These results can help to identify patients with greater severity; however, more research is required to control posible confounding variables through sensitivity and specificity analysis.