open access

Ahead of print
Original Article
Submitted: 2021-05-16
Accepted: 2021-10-19
Published online: 2021-11-15
Get Citation

Mean platelet volume-to-platelet count ratio after elective cardiac surgical procedures is superior in reflecting platelets metabolic hyperactivity compared to other routine morphological platelet indices: A preliminary report

Bartłomiej Perek1, Piotr Rzymski23, Anna Komosa4, Anna Olasińska-Wiśniewska1, Mateusz Puślecki15, Marek Jemielity1, Maciej Lesiak4, Sleiman Sebastian Aboul-Hassan67, Tomasz Stankowski8, Zhengyuan Xia9, Konrad Stelmark1, Jolanta Siller-Matula10, Barbara Poniedziałek2
Affiliations
  1. Department of Cardiac Surgery and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Environmental Medicine, Poznan University of Medical Sciences, Poznan, Poland
  3. Integrated Science Association (ISA), Universal Scientific Education and Research Network (USERN)
  4. 1st Department of Cardiology, Poznan University of Medical Sciences, Poland
  5. Department of Medical Rescue, Poznan University of Medical Sciences, Poland
  6. Department of Cardiac Surgery, Medinet Heart Center Ltd, Nowa Sol, Poland
  7. Department of Cardiac Surgery and Interventional Cardiology, Faculty of Medicine and Medical Sciences, University of Zielona Gora, Zielona Gora, Poland
  8. Department of Cardiac Surgery, Sana-Herzzentrum, Cottbus, Germany
  9. Shenzhen Institute of Research and Innovation, The University of Hong Kong, China
  10. Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, Austria

open access

Ahead of print
Original articles
Submitted: 2021-05-16
Accepted: 2021-10-19
Published online: 2021-11-15

Abstract

Background: Excessive metabolic excitation of platelets after cardiac procedures may be related to some adverse events but assessment of their metabolic activity is not routine. The purpose of this study was to evaluate which of the basic platelet morphological parameters best reflects their metabolic status. Methods: The blood samples of 22cardiac surgical patients (mean age of 62.3 ± 10.3 years) were taken before surgery (BS), and 1, 24 and 48 hours after the operation. Correlations between morphological platelet parameters (platelet count [PLT], mean platelet volume [MPV], platelet distribution width [PDW] and MPV/PLT) and their metabolic activity (total concentration of malondialdehyde [MDA] and MDA/PLT) were estimated. Results: Significant decline in PLT after operation (from 223 ± 44 × 1012/L to 166 ± 57 × 1012/L) was accompanied by marked increase in MPV (from 8.4 ± 0.9 fL to 9.1 ± 1.2 fL) and no change of PDW. Consequently, MPV/PLT index increased significantly after procedures from (median with IQR) 0.038 (0.030–0.043) to 0.053 (0.043–0.078). Simultaneously, a significant increase in total platelet MDA content and MDA/PLT was noted reaching peak levels soon after operation. The strongest correlation was observed between MPV/PLT and MDA/PLT (r = 0.56; p < 0.001), although the others were also found to be significant (MDA/PLT vs. MPV; r = 0.35; MDA/PLT vs. PDW; r = 0.34). Conclusions: Among basic morphological parameters and indices, the MPV-to-PLT ratio reflects the best metabolic status of platelets in cardiac surgical patients.

Abstract

Background: Excessive metabolic excitation of platelets after cardiac procedures may be related to some adverse events but assessment of their metabolic activity is not routine. The purpose of this study was to evaluate which of the basic platelet morphological parameters best reflects their metabolic status. Methods: The blood samples of 22cardiac surgical patients (mean age of 62.3 ± 10.3 years) were taken before surgery (BS), and 1, 24 and 48 hours after the operation. Correlations between morphological platelet parameters (platelet count [PLT], mean platelet volume [MPV], platelet distribution width [PDW] and MPV/PLT) and their metabolic activity (total concentration of malondialdehyde [MDA] and MDA/PLT) were estimated. Results: Significant decline in PLT after operation (from 223 ± 44 × 1012/L to 166 ± 57 × 1012/L) was accompanied by marked increase in MPV (from 8.4 ± 0.9 fL to 9.1 ± 1.2 fL) and no change of PDW. Consequently, MPV/PLT index increased significantly after procedures from (median with IQR) 0.038 (0.030–0.043) to 0.053 (0.043–0.078). Simultaneously, a significant increase in total platelet MDA content and MDA/PLT was noted reaching peak levels soon after operation. The strongest correlation was observed between MPV/PLT and MDA/PLT (r = 0.56; p < 0.001), although the others were also found to be significant (MDA/PLT vs. MPV; r = 0.35; MDA/PLT vs. PDW; r = 0.34). Conclusions: Among basic morphological parameters and indices, the MPV-to-PLT ratio reflects the best metabolic status of platelets in cardiac surgical patients.

Get Citation

Keywords

cardiac operation, platelet, mean platelet volume, malondialdehyde

About this article
Title

Mean platelet volume-to-platelet count ratio after elective cardiac surgical procedures is superior in reflecting platelets metabolic hyperactivity compared to other routine morphological platelet indices: A preliminary report

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-11-15

Page views

1493

Article views/downloads

406

DOI

10.5603/CJ.a2021.0150

Pubmed

34787889

Keywords

cardiac operation
platelet
mean platelet volume
malondialdehyde

Authors

Bartłomiej Perek
Piotr Rzymski
Anna Komosa
Anna Olasińska-Wiśniewska
Mateusz Puślecki
Marek Jemielity
Maciej Lesiak
Sleiman Sebastian Aboul-Hassan
Tomasz Stankowski
Zhengyuan Xia
Konrad Stelmark
Jolanta Siller-Matula
Barbara Poniedziałek

References (35)
  1. Paparella D, Rotunno C, Guida P, et al. Minimally invasive heart valve surgery: influence on coagulation and inflammatory response. Interact Cardiovasc Thorac Surg. 2017; 25(2): 225–232.
  2. Hamano K, Kawamura T, Gohra H, et al. Stress caused by minimally invasive cardiac surgery versus conventional cardiac surgery: incidence of systemic inflammatory response syndrome. World J Surg. 2001; 25(2): 117–121.
  3. Durandy Y. Minimizing systemic inflammation during cardiopulmonary bypass in the pediatric population. Artif Organs. 2014; 38(1): 11–18.
  4. Squiccimarro E, Labriola C, Malvindi PG, et al. Prevalence and clinical impact of systemic inflammatory reaction after cardiac surgery. J Cardiothorac Vasc Anesth. 2019; 33(6): 1682–1690.
  5. Boehne M, Sasse M, Karch A, et al. Systemic inflammatory response syndrome after pediatric congenital heart surgery: Incidence, risk factors, and clinical outcome. J Card Surg. 2017; 32(2): 116–125.
  6. Sasse M, Dziuba F, Jack T, et al. In-line filtration decreases systemic inflammatory response syndrome, renal and hematologic dysfunction in pediatric cardiac intensive care patients. Pediatr Cardiol. 2015; 36(6): 1270–1278.
  7. Ho-Tin-Noé B, Boulaftali Y, Camerer E. Platelets and vascular integrity: how platelets prevent bleeding in inflammation. Blood. 2018; 131(3): 277–288.
  8. Rodrigues M, Kosaric N, Bonham CA, et al. Wound healing: a cellular perspective. Physiol Rev. 2019; 99(1): 665–706.
  9. Vlot EA, Willemsen LM, Van Dongen EPA, et al. Perioperative point of care platelet function testing and postoperative blood loss in high-risk cardiac surgery patients. Platelets. 2019; 30(8): 982–988.
  10. Paniccia R, Priora R, Liotta AA, et al. Platelet function tests: a comparative review. Vasc Health Risk Manag. 2015; 11: 133–148.
  11. Lordkipanidzé M. Platelet function tests. Semin Thromb Hemost. 2016; 42(3): 258–267.
  12. Würtz M, Hvas AM, Christensen KH, et al. Rapid evaluation of platelet function using the Multiplate® Analyzer. Platelets. 2014; 25(8): 628–633.
  13. Komosa A, Rzymski P, Perek B, et al. Platelets redox balance assessment: Current evidence and methodological considerations. Vascul Pharmacol. 2017; 93-95: 6–13.
  14. Polzin A, Dannenberg L, Schneider T, et al. Malondialdehyde assay in the evaluation of aspirin antiplatelet effects. Pharmacology. 2019; 103(1-2): 23–29.
  15. Vagdatli E, Gounari E, Lazaridou E, et al. Platelet distribution width: a simple, practical and specific marker of activation of coagulation. Hippokratia. 2010; 14(1): 28–32.
  16. Tian C, Song J, He D, et al. Predictive value of mean platelet volume/platelet count for prognosis in acute myocardial infarction. Int Heart J. 2018; 59(2): 286–292.
  17. Komosa A, Perek B, Rzymski P, et al. Transcatheter aortic valve replacement is associated with less oxidative stress and faster recovery of antioxidant capacity than surgical aortic valve replacement. J Clin Med. 2019; 8(9).
  18. Chung MK. Correlation Coefficient. In: Salkin NJ, ed. Encyclopedia of Measurement and Statistics. Sage Publications, London 2007: 189–201.
  19. Karhausen JA, Smeltz AM, Akushevich I, et al. Platelet counts and postoperative stroke after coronary artery bypass grafting surgery. Anesth Analg. 2017; 125(4): 1129–1139.
  20. Romlin BS, Söderlund F, Wåhlander H, et al. Platelet count and function in paediatric cardiac surgery: a prospective observational study. Br J Anaesth. 2014; 113(5): 847–854.
  21. Squiccimarro E, Jiritano F, Serraino GF, et al. Quantitative and qualitative platelet derangements in cardiac surgery and extracorporeal life support. J Clin Med. 2021; 10(4).
  22. Ichikawa J, Osada Y, Kodaka M, et al. Association Between Platelet Count and Postoperative Blood Loss in Patients Undergoing Cardiac Surgery With Cardiopulmonary Bypass and Fresh Frozen Plasma Administration Guided by Thromboelastometry. Circ J. 2018; 82(3): 677–683.
  23. Lopes CT, Dos Santos TR, Brunori EH, et al. Excessive bleeding predictors after cardiac surgery in adults: integrative review. J Clin Nurs. 2015; 24(21-22): 3046–3062.
  24. Van Poucke S, Stevens K, Wetzels R, et al. Early platelet recovery following cardiac surgery with cardiopulmonary bypass. Platelets. 2016; 27(8): 751–757.
  25. Haponiuk I, Chojnicki M, Jaworski R, et al. Inflammatory marker levels after hybrid treatment of selected congenital heart disease in children. Kardiol Pol. 2014; 72(9): 798–805.
  26. Miceli A, Gilmanov D, Murzi M, et al. Evaluation of platelet count after isolated biological aortic valve replacement with Freedom Solo bioprosthesis. Eur J Cardiothorac Surg. 2012; 41(1): 69–73.
  27. Chen S, Su Y, Wang J. ROS-mediated platelet generation: a microenvironment-dependent manner for megakaryocyte proliferation, differentiation, and maturation. Cell Death & Disease. 2013; 4(7): e722–e722.
  28. Gasparyan AY, Ayvazyan L, Mikhailidis DP, et al. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011; 17(1): 47–58.
  29. Hecker M, Haurand M, Ullrich V, et al. Products, kinetics, and substrate specificity of homogeneous thromboxane synthase from human platelets: development of a novel enzyme assay. Arch Biochem Biophys. 1987; 254(1): 124–135.
  30. Hovinga JK, Felix R, Furlan M, et al. Malondialdehyde formation by blood platelets: a diagnostic test to assess acetylsalicylic acid induced thrombocytopathy? Thromb Res. 1990; 59(1): 89–95.
  31. Kaya U, Koza Y. Predictive value of mean platelet volume in saphenous vein graft disease. Braz J Cardiovasc Surg. 2018; 33(4): 317–322.
  32. Pala AA, Urcun YS. Is the mean platelet volume a predictive factor for atrial fibrillation developing after coronary artery bypass grafting in elderly patients? Heart Surg Forum. 2020; 23(6): E809–E814.
  33. Wang XY, Yu HY, Zhang YY, et al. Serial changes of mean platelet volume in relation to Killip Class in patients with acute myocardial infarction and primary percutaneous coronary intervention. Thromb Res. 2015; 135(4): 652–658.
  34. Cakici M, Cetin M, Balli M, et al. Predictors of thrombus burden and no-reflow of infarct-related artery in patients with ST-segment elevation myocardial infarction: importance of platelet indices. Blood Coagul Fibrinolysis. 2014; 25(7): 709–715.
  35. Tüysüz ME, Dedemoğlu M. High mean platelet volume to platelet count ratio as a predictor on poor outcomes after CABG. Gen Thorac Cardiovasc Surg. 2020; 68(5): 459–466.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By VM Media Group sp. z o.o., Grupa Via Medica, ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl