Can platelet indices predict obstruction level of pulmonary vascular bed in patients with acute pulmonary embolism?

Clin Respir J. 2014 Jan;8(1):33-40. doi: 10.1111/crj.12031. Epub 2013 Jul 31.

Abstract

Introduction: Computed tomography pulmonary arterial obstruction index ratio (CTPAOIR) is related with the severity of pulmonary embolism (PE). Platelet indices including mean platelet volume (MPV), platelet distribution width (PDW) are reported to be increased in acute PE.

Objective: In this study, we aimed to evaluate the relationship between CTPAOIR and platelet indices and the utility of these parameters in the determination of PE severity.

Materials and methods: We retrospectively analysed the demographic data, clinical probability scores, laboratory data and echocardiographic findings of 63 acute PE patients who were diagnosed by pulmonary arterial computed tomography angiography.

Results: The hospital records of 38 (60.3%) male and 25 (39.7%) female patients with acute PE and 29 (58%) male and 21 (42%) female healthy control were evaluated (P = 0.803). The mean value of MPV, PDW levels, platelet counts and red cell distribution width levels were higher in PE groups than in control subjects (P < 0.05). Massive PE was present in 33.3% of PE patients. There were statistically significant differences in terms of hospital length of stay (HLS), mean value of MPV, CTPAOIR and systolic pulmonary arterial pressure (sPAP) in addition to systolic arterial pressure between massive and submassive PE patients (P < 0.05 for all). CTPAOIR was positively correlated with HLS, clinical probability scores, D-Dimer level, MPV, PDW levels and sPAP.

Conclusion: Platelet indices, MPV and PDW, can be used for the determination of disease severity, and lead to therapeutic strategies for PE patients.

Keywords: acute pulmonary embolism; computed tomography pulmonary arterial obstruction index ratio; computerised tomography; mean platelet volume; platelet indices; severity of pulmonary embolism.

MeSH terms

  • Acute Disease
  • Aged
  • Female
  • Humans
  • Length of Stay
  • Male
  • Mean Platelet Volume
  • Middle Aged
  • Platelet Function Tests*
  • Pulmonary Artery / pathology
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / diagnostic imaging
  • Pulmonary Embolism / physiopathology*
  • Retrospective Studies
  • Severity of Illness Index
  • Tomography, X-Ray Computed
  • Ultrasonography