What does it mean to have high Mean Platelet Volume (MPV)?

From the Guidelines

High mean platelet volume (MPV) is an indicator of larger than average platelets, which can suggest rapid platelet production in response to various conditions, and while it doesn't typically require specific treatment, addressing the underlying cause is crucial. The size of platelets can reflect their function and production, with normal MPV ranges from 7.5 to 11.5 femtoliters (fL) [no specific reference provided in the given evidence]. High MPV often indicates that the bone marrow is producing platelets more rapidly, resulting in larger, younger platelets being released into circulation. This can occur in response to conditions like platelet destruction, bone marrow recovery, or inflammation.

Key Points to Consider

• High MPV can be associated with various conditions, including immune thrombocytopenia, recovery from chemotherapy, cardiovascular disease, diabetes, and certain medications.
• The evidence provided does not directly address high mean platelet volume, but it discusses the management of bleeding following major trauma, including the role of platelet transfusion and the maintenance of adequate platelet counts 1.
• It is essential to determine the underlying cause of high MPV, as it can sometimes indicate an increased risk for blood clots, particularly in individuals with other cardiovascular risk factors.
• The provided evidence focuses on the management of bleeding and platelet transfusion thresholds, suggesting that a platelet count of at least 50 × 10^9/l should be maintained following injury, with some consensus groups recommending higher thresholds in specific situations 1.
• While the evidence does not directly link high MPV to treatment strategies, monitoring and addressing the underlying cause of high MPV are critical to prevent potential complications, such as blood clots.

From the Research

Definition of High Mean Platelet Volume

• High mean platelet volume (MPV) is a condition where the average size of platelets in the blood is larger than normal 2, 3, 4.
• MPV is a marker of platelet function and activation, and an elevated MPV is associated with acute coronary syndromes (ACS) and other prothrombotic and proinflammatory diseases 2, 3.

Association with Diseases

• High MPV has been observed in various diseases, including:
  • Cardiovascular diseases 2, 3, 5
  • Cerebral stroke 3
  • Respiratory diseases 3
  • Chronic renal failure 3
  • Intestine diseases 3
  • Rheumatoid diseases 3
  • Diabetes 3
  • Various cancers 3
• Decreased MPV has been noted in certain conditions, such as tuberculosis, ulcerative colitis, and systemic lupus erythematosus (SLE) 3.

Effect of Aspirin on MPV

• Aspirin therapy does not appear to affect MPV levels in patients with paroxysmal atrial fibrillation 6 or healthy volunteers 4.
• However, one study found a paradoxical increase in MPV after starting antiplatelet therapy with aspirin and clopidogrel in patients with acute coronary syndromes 5.

Clinical Significance

• High MPV may be a useful predictive and prognostic biomarker of cardiovascular events and other inflammatory conditions 2, 3.
• The study of MPV can provide important information on the course and prognosis of many inflammatory conditions, and may help identify patients at increased risk of thrombotic complications or death 3.