Mean Platelet Volume as Marker of Thrombosis Event in Antiphospholipid Syndrome Patients

Michael Dwinata, Jonathan H. Haposan, Inolyn Pandjaitan


Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease associated with venous and/or arterial thrombosis with the presence and persistence of antiphospholipid antibodies (aPL). One of the currently discussed markers related to a high risk of thromboembolism is increased Mean Platelet Volume (MPV). This study aimed to know whether an association exists between MPV and thrombosis event in APS patients. We systematically searched and reviewed studies from MEDLINE, Science Direct and the Cochrane Controlled Trials registry (CENTRAL) from October until November 2018. We use appraisal tools from Critical Appraisal Skills Programme (CASP-UK) for cohort studies. We found two relevant studies to be included in our review.In total, 389 patients consisting 92 APS patient and 297 APS-negative and healthy controls were included. In two studies, the mean of MPV in APS group with thrombosis ranged from 7.85 to 9.22 fl. MPV in APS group with thrombosis was higher than in the APS group without thrombosis and in healthy controls. The platelet size, measured as MPV, reflects platelet reactivity, including aggregation, glycoprotein IIb-IIIa expression and production of more thrombogenic factors. In summary, MPV has a positive correlation with thrombosis event in APS patient. MPV may also be a potential clinical predictor for recurrence of thrombosis in APS patient. We urge that more future prospective studies with larger sample size to be done in order to validate this potential marker.

Keywords : Mean platelet volume, thrombosis, antiphospholipid syndrome


Mean platelet volume; thrombosis; antiphospholipid syndrome


Garcia D et Erkan D. Diagnosis and Management of Antiphospholipid Syndrome. N Engl J Med. 2018; 378:2010-2021.

Miyakis S, Lockshin MD, Atsumi T, Branch W, Brey RL, Cervera R, et al,. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4: 295–306.

Mchrani T, Petri M. Epidemiology of the antiphospholipid syndrome. In: Asherson RA, editor. Hanbook of systemic autoimmune diseases, vol. 10. Amsterdam: Elsevier; 2009. p. 13–34.

Khamastha MA (Ed). Hughes Syndrome: Antiphospholipid syndrome. 2nd Edition. London: Springer-Verlag London Limited; 2006.

Merashli M, Noureldine MH, Uthman I, Khamashta M. Antiphospholipid syndrome: an update. European journal of clinical investigation. 2015 Jun;45(6):653-62.

Unlu O, Zuily S, Erkan D. The clinical significance of antiphospholipid antibodies in systemic lupus erythematosus. Eur J Rheumatol. 2016; 3: 75-84.

Pierangeli SS, Chen PP, Raschi E, Scurati S, Grossi C, Borghi MO, et al. Antiphospholipid antibodies and the antiphospholipid syndrome: Pathogenic mechanisms. Semin Thromb Hemost. 2008;34:236–250.

Gasparyan AY, Stavropoulos-Kalinoglou A, Mikhailidis DP, Douglas KM, Kitas GD. Platelet function in rheumatoid arthritis: Arthritic and cardiovascular implications. Rheumatol Int. 2011;31: 153–164.

Baroni G, Banzato A, Bison E, Denas G, Zoppellaro G, Pengo V. The role of platelets in antiphospholipid syndrome. Platelets. 2017 Nov 17;28(8):762-6.

Braekkan SK, Mathiesen EB, Njolstad I, Wilsgaard T, Stormer J, Hansen JB. Mean platelet volume is a risk factor for venous thromboembolism: the Tromso study, Tromso, Norway. J Thromb Haemost. 2010;8:157–162.

Chu SG, Becker RC, Berger PB, Bhatt DL, Eikelboom JW, Konkle B et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost. 2010;8:148–156.

Korkmaz S, Uslu AU, Sahin S, Senel S, Sencan M. Is there a link between mean platelet volume and thrombotic events in antiphospholipid syndrome? Platelets. 2014;25(5):343-7.

Rupa-Matysek J, Wojtasinka E, Ciepluch K, Lewandowska M, Komarnicki M. The relationship between mean platelet volume and thrombosis recurrence in patients diagnosed with antiphospholipid syndrome. Rheumatol Int. 2014;34(11): 1599–1605.

Meroni PL, Borghi MO, Raschi E, Tedesco F. Pathogenesis of antiphospholipid syndrome: Understanding the antibodies. Nat Rev Rheumatol 2011;7(6):330–339.

Vlachoyiannopoulos PG, Routsias JG. A novel mechanism of thrombosis in antiphospholipid antibody syndrome. J Autoimmun. 2010;35(3):248–255.

Endler G, Klimesch A, Sunder-Plassmann H, Schillinger M, Exner M, Mannhalter C, et al. Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol. 2002;117:399–404.

Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke. 2004;35:1688–1691.

Mayda-Domac F, Misirli H, Yilmaz M. Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke. J Stroke Cerebrovasc Dis. 2010;19:66–72.

Paramo JA, Rocha E. Deep vein thrombosis and related platelet changes after total hip replacement. Haemostasis. 1985;15: 389–394.

Kostrubiec M, Labyk A, Pedowska-Wloszek J, Hrynkiewicz- Szyman´ska A, Pacho S, Jankowski K, Lichodziejewska B,Pruszczyk P. Mean platelet volume predicts early death in acute pulmonary embolism. Heart. 2010;96:460–465.

Turner-Stokes L, Jones D, Patterson KG, Todd-Pokropek A, Isenberg DA, Goldstone AH. Measurement of haematological indices of chronic rheumatic disease with two newer generation automated systems, the H1 and H6000 (Technicon). Ann Rheum Dis. 1991;50:583–587.

Dasanu CA, Codreanu I. Isolated thrombocytopenia: should we routinely screen for antiphospholipid antibodies? Conn Med. 2011;75:281–284.

Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: A link between thrombosis and inflammation? Curr Pharm Des. 2011;17:47–58.

Kamath S, Blann AD, Lip GY. Platelet activation: assessment and quantification. Eur Heart J. 2001; 22:1561–1571.

Bath PM, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood Coagul Fibrinolysis. 1996; 7:157–161.

Dastjerdi MS, Emami T, Najafian A, Amini M. Mean platelet volume measurement, EDTA or citrate? Hematology. 2006;11: 317-9.

McShine RL, Sibinga S, Brozovic B. Differences between the effects of EDTA and citrate anticoagulants on platelet count and mean platelet volume. Clin Lab Haematol 1990; 12: 277-85.



  • There are currently no refbacks.