Usefulness of mean platelet volume for predicting stroke risk in paroxysmal atrial fibrillation patients

Abstract

Atrial fibrillation is the most common sustained arrhythmia in clinical practice. It is important to specify patients with a high risk of thromboembolus due to elevated procoagulant and prothrombotic state. The aim of this study is to assess the relation of stroke/transient ischaemic attack (TIA) with mean platelet volume (MPV), which is an indicator of platelet activation in patients with paroxysmal atrial fibrillation (PAF). Patients with PAF were enrolled in this study during years of 2012-2014. Patients were divided into two groups according to the presence or absence of stroke/TIA. Demographic data were registered and CHA2DS2VASc scores of patients were calculated. It was investigated whether there was a difference among groups regarding MPV levels. Ninety patients, 31 of whom had history of stroke/TIA (symptomatic group), were enrolled to study. CHA2DS2VASc score of symptomatic group was 4.77 ± 1.26, while CHA2DS2VASc score of asymptomatic group was 2.63 ± 1.41. Nevertheless, there was not any difference regarding CHA2DS2VASc score among two groups when 2 points due to stroke/TIA were subtracted in symptomatic patients. MPV was detected higher in symptomatic patients than asymptomatic patients (11.1 ± 1.3 vs. 9.1 ± 1.0 fL, P < 0.001, respectively). A value of 9.85 for the MPV ascertained with receiver operating characteristic (ROC) curve analysis to predict stroke/TIA was found to have a sensitivity of 87% and specificity of 78%. Elevated MPV levels were ascertained to be related with stroke/TIA in patients with PAF. Assessment of MPV apart from CHA2DS2VASc score in patients with PAF might be subsidiary to specify patients with an enhanced risk of stroke/TIA.