Mean platelet volume: a new predictor of ischaemic stroke risk in patients with nonvalvular atrial fibrillation

BACKGROUND: Mean platelet volume (MPV) has been identified as an individual risk factor for stroke and thrombosis. Concurrently, ischaemic stroke caused by nonvalvular atrial fibrillation (AF) has attracted increasing attention. The aim of this study was to investigate the association between MPV and the risk of ischaemic stroke in AF patients not receiving anticoagulant therapy. METHODS: A total of 370 patients with nonvalvular AF were enrolled. Patients were divided into a control group and a stroke group according to the presence of ischaemic stroke. RESULTS: The MPV level and CHA2DS2-VASc scores of the stroke group were higher than those of the control group (all p < 0.001). The ischaemic stroke event rates were significantly increased in the highest MPV tertile when compared to the lowest MPV tertile (56.9% vs. 30.3%, p < 0.001). Multivariate logistic regression analysis showed that CHA2DS2-VASc, MPV and D-dimer (D2) were predictors of ischaemic stroke [all p < 0.05]. The receiver operating characteristic (ROC) curve analysis indicated that an MPV value of 11.65 fL could predict ischaemic stroke with a sensitivity of 67.3% and specificity of 58.5%, while a CHA2DS2-VASc score cutoff value 3.5 had a sensitivity of 52.1% and specificity of 87.3%. The predictive value of the combined model of CHA2DS2-VASc+MPV was higher than others (comparison calculated by using MedCalc software). The sensitivity of the CHA2DS2-VASc score combined with MPV for predicting ischaemic stroke was 72.1%, and the specificity was 81.5%. CONCLUSIONS: MPV could be a new predictor of ischaemic stroke risk in patients with AF. Moreover, the CHA2D2S2-VASc combined with MPV can improve predictive value with higher sensitivity and it could be a powerful tool for stratifying patients in terms of ischaemic stroke risk.