Mean platelet volume (MPV) and platelet distribution width (PDW) predict clinical outcome of acute ischemic stroke: A systematic review and meta-analysis

A potential relationship between poor clinical outcome and mean platelet volume (MPV), platelet distribution width (PDW) have been suggested by previous studies in acute ischemic stroke (AIS), but the conclusions continued to be controversial. Here, we performed meta-analysis of available studies to explore the effect of MPV, PDW on clinical outcomes in AIS. A systematic literature search was performed in PubMed, EMBASE, and Cochrane Library up to 21 Dec 2021. A total of 10 articles related to MPV and 4 articles related to PDW on the clinical outcome of AIS including 2,390 patients were enrolled in the meta-analysis. The overall result showed that MPV was decreased in favorable outcome group when compared with unfavorable outcome group [SMD (95%CI) = -0.52 (-0.80, -0.24)]. Subgroup analysis indicated that such trend was consistent in the retrospective study, prospective study, non-thrombolytic, EDTA anticoagulants, Sysmax hematology analyzers and detection time within 2 h. In the meta-analysis of PDW, the overall result and subgroup analyses of favorable outcome group did not observe the significant difference compared with unfavorable outcome group. In this meta-analysis, we found remarkable between-study heterogeneity, but Begg's test and Egger's test did not detect publication bias. In conclusion, this meta-analysis result suggested that elevated MPV may be a predictive marker of adverse clinical outcome of AIS, especially in non-thrombolytic patients, while PDW has insufficient value in predicting clinical outcome of AIS. SYSTEMATIC REVIEW REGISTRATION: This meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42022299316. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=299316).