Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension
Mehmet A Erdogan, Ali R Benli, Serap B Acmali, Mustafa Koroglu, Yahya Atayan, Ahmet Danalioglu, Burcak Kayhan
Citation Information :
Erdogan MA, Benli AR, Acmali SB, Koroglu M, Atayan Y, Danalioglu A, Kayhan B. Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension. Euroasian J Hepatogastroenterol 2017; 7 (1):6-10.
To investigate whether mean platelet volume (MPV) is a predictor of variceal bleeding in patients with cirrhotic portal hypertension.
Materials and methods
This prospective cohort was performed in the internal medicine department of our tertiary care center. Cirrhotic patients were allocated into two groups: Group I consisted of 31 cases without a history of variceal bleeding, whereas group II was made up of 31 patients with a history of variceal bleeding. Data derived from medical history, physical examination, ultrasonography, gastrointestinal system endoscopy, complete blood count, hepatic, and renal function tests were recorded and compared between two groups. On physical examination, encephalopathy and ascites were evaluated and graded with respect to Child–Pugh–Turcotte classification.
Results
There was no significant difference between the two groups in terms of age, duration of the disease, and gender of the patient. The only remarkable difference was that hemoglobin (p = 0.02) and hematocrit (p = 0.02) values were lower in group II. Neither the etiology of bleeding was different between groups nor did MPV seem to have a noteworthy impact on bleeding. Interestingly, risk of variceal bleeding increased in parallel to the higher grade of varices.
Conclusion
Our results imply that there is a correlation between the grade of varices and esophageal variceal bleeding in cirrhotic patients. However, association between MPV and variceal bleeding could not be demonstrated. Utilization of noninvasive tests as predictors in these patients necessitates further controlled trials on larger series.
How to cite this article
Erdogan MA, Benli AR, Acmali SB, Koroglu M, Atayan Y, Danalioglu A, Kayhan B. Predictive Value of Mean Platelet Volume in Variceal Bleeding due to Cirrhotic Portal Hypertension. Euroasian J Hepato-Gastroenterol 2017;7(1):6-10.
Color Doppler ultrasonography is reliable in assessing the risk of esophageal variceal bleeding in patients with liver cirrhosis. Wien Klin Wochenschr 2005 Oct;117(19-20):711-717.
Prospective study of diagnosis, therapy and follow-up of acute gastrointestinal hemorrhage in 397 patients. Wien klin Wochenschr 1996 Nov;108(22):717-721.
Hemodynamic analysis of esophageal varices using color Doppler endoscopic ultrasonography to predict recurrence after endoscopic treatment. Endoscopy 2001 Oct;33(10):869-872.
Platelet count/spleen diameter ratio: proposal and validation of a non-invasive parameter to predict the presence of oesophageal varices in patients with liver cirrhosis. Gut 2003 Aug;52(8): 1200-1205.
Value of splanchnic Doppler ultrasound in the diagnosis of portal hypertension. Ultrasound Med Biol 2001 Jul;27(7):893-899.
Baseline platelet indices and bleeding after transcatheter aortic valve implantation. Blood Coagul Fibrinolysis 2015 Jul;26(5):527-532.
Mean platelet volume is an independent risk factor for myocardial infarction but not for coronary artery disease. Br J Haematol 2002 May;117(2):399-404.
Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004 Mar;35(3):622-626.
Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010 Jan;8(1):148-156.
Impact of mean platelet volume on combined safety endpoint and vascular and bleeding complications following percutaneous transfemoral transcatheter aortic valve implantation. BioMed Res Int 2013 Nov;2013(2013):1-8.
The association of mean platelet volume with intra ventricular hemorrhage and broncho pulmonary dysplasia in preterm infants. Iran J Ped Hematol Oncol 2015 Dec;5(4):227-232.
Risk factors for the presence of varices in cirrhotic patients without a history of variceal hemorrhage. Arch Intern Med 2001 Nov;161(21):2564-2570.
Non- invasive predictors of the presence of large oesophageal varices in patients with cirrhosis. Dig Liver Dis 2003 Jul;35(7): 473-478.
Clinical predictors of bleeding esophageal varices in the ED. Am J Emerg Med 2005 Jul;23(4):531-535.
Variceal pressure is a factor predicting the risk of a first variceal bleeding: a prospective cohort study in cirrhotic patients. Hepatology 1998 Jan;27(1):15-19.
Use of ß‐blocker therapy to prevent primary bleeding of esophageal varices. J Am Acad Nurse Pract 2010 Dec;22(12):640-647.
Meta-analysis of value of propranolol in prevention of variceal haemorrhage. Lancet 1990 Jul;336(8708):153-156.
Relation between portal pressure response to pharmacotherapy and risk of recurrent variceal haemorrhage in patients with cirrhosis. Lancet 1995 Oct;346(8982):1056-1059.
Gastrointestinal injury associated with NSAID use: a case study and review of risk factors and preventative strategies. Drug Healthc Patient Saf 2015 Jan;7:31-41.
Risk factors of acute ulcer bleeding. Hepato-gastroenterology 1999;46(26):727-731.
; Dooley J. Diseases of the liver and biliary system. John Wiley & Sons; 2008. p. 728.
Etiology of liver cirrhosis in Japan: a nationwide survey. J Gastroenterol 2010;45(1):86-94.
Etiology of liver cirrhosis in Mexico. Ann Hepatol 2004 Jan-Mar;3(1):30-33.
Beyond the platelet count: immature platelet fraction and thromboelastometry correlate with bleeding in patients with immune thrombocytopenia. Br J Haematol 2014 Aug;166(4):592-600.
