Thromb Haemost 2017; 117(06): 1129-1140
DOI: 10.1160/TH16-12-0974
Cellular Haemostasis and Platelets
Schattauer GmbH

Mean platelet volume is associated with lower risk of overall and non-vascular mortality in a general population

Results from the Moli-sani study
Marialaura Bonaccio
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Augusto Di Castelnuovo
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Simona Costanzo
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Amalia De Curtis
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Mariarosaria Persichillo
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Chiara Cerletti
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Maria Benedetta Donati
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Giovanni de Gaetano
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
,
Licia Iacoviello
1  Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo NEUROMED, Pozzilli (IS), Italy
2  Department of Medicine and Surgery, University of Insubria, Varese, Italy
,
the Moli-sani Study Investigators› Author Affiliations
Financial support: The enrolment phase of the Moli-sani study was supported by research grants from Pfizer Foundation (Rome, Italy), the Italian Ministry of University and Research (MIUR, Rome, Italy)–Programma Triennale di Ricerca, Decreto no.1588 and Instrumentation Laboratory, Milan, Italy. Funders had no role in study design, collection, analysis, and interpretation of data; in the writing of the manuscript and in the decision to submit the article for publication. Marialaura Bonaccio was supported by a Fondazione Umberto Veronesi Fellowship. All Authors were and are independent from funders. The present analyses were partially supported by the Italian Ministry of Health 2013 (Young investigator grant to MB, number: GR-2013–02356060) and by the Italian Association for Cancer Research (A. I. R. C.) with grant AIRC “5 × 1000” Ref. n. 12237.
Further Information

Publication History

Received: 30 December 2016

Accepted after major revision: 19 March 2017

Publication Date:
28 November 2017 (online)

Summary

Larger mean platelet volume (MPV) has been associated with adverse health outcomes in high-risk populations or patients with cardiovascular disease (CVD). We tested the association of MPV with mortality in a prospective cohort study including 17,402 subjects randomly recruited from an adult general population within the Moli-sani study (2005–2010). Two distinct subgroups (with or without CVD at baseline) were subsequently analysed. Hazard ratios (HR) were calculated using multivariable Cox-proportional hazard models. Over a median follow up of eight years (137,547 person-years), 925 all-cause deaths occurred (330 vascular, 351 cancer and 244 other deaths). In a multivariable model, the highest MPV quintile (mean MPV=10.0 fL), as compared to the lowest one, was associated with reduced risk of overall mortality (HR=0.79; 95 % confidence interval 0.64–0.98), cancer death (HR=0.70; 0.49–1.00) and death from other non- vascular/non cancer causes (HR=0.55; 0.36–0.84) but not with vascular mortality. The inverse association with overall death appeared even stronger in the subgroup without CVD at baseline (HR=0.64; 0.50–0.81). In contrast, within 920 subjects reporting a previous CVD event, larger MPV was associated with higher risk of total mortality (HR=1.69; 1.05–2.72; p for interaction=0.048) and with a trend of risk for other cause-specific deaths. In conclusion, larger MPV is associated with lower risk of overall and non-vascular death in subjects apparently free from CVD, but appears to be a predictive marker of death in patients with CVD history. The latter is a likely effect modifier of the association between MPV and death.

* Moli-sani study Investigators are listed in Appendix.