Cite as: Varol E. Mean platelet volume in supraventricular tachyarrhythmia can be affected by many cardiovascular risk factors. African Health Sciences 2013; 13(4): 1176 – 1177 (L2)
We read the article by Ocak et al. with a great interest.1 They compared mean platelet volume (MPV) in patients with supraventricular tachyarrhythmia (SVT) and in healthy controls. They found that MPV in the SVT group was significantly higher than in the control group and MPV was an independent predictor of SVT. Although this is a well designed study, we would like to offer minor criticism about this study from methodological aspect.
Basically, the method of MPV measurement is correct. However, it has to be kept in mind that there are significant associations of MPV with type 2 diabetes mellitus, pre-diabetes, smoking, hypertension, hypercholesterolemia, obesity, coronary heart disease, metabolic syndrome, statins, antihypertensive drug use and atrial fibrillation.2–4 The authors did not mention body mass index, blood pressure and levels of glucose and lipids in patients with SVT and control subjects. It has been demonstrated that obesity, type 2 diabetes mellitus, pre-diabetes, hypertension, hypercholesterolemia and metabolic syndrome increase MPV.2–4 In addition, in the text p value was p<0.001 for comparison of the MPV between SVT patients and controls. However, the same p value was 0.89 in the table 1. I think, it was written by wrongly. Recently, Atalar et al. demonstrated that there was no platelet activation in patients with SVT during tachyarrhythmia but significantly increased platelet activity in patients with paroxysmal atrial fibrillation and chronic atrial fibrillation by measuring beta-thromboglobulin and platelet factor 4 during tachyarrhythmia attacks.5 However, their sample size was small.
Recently, MPV has gained great attention especially in cardiovascular disease in diagnostic and prognostic aspect. In comparison to smaller ones, larger platelets have more granules, aggregate more rapidly with collagen, have higher thromboxane A2 level and express more glycoprotein Ib and IIb/IIIa receptors.2 We believe that MPV can be affected by many cardiovascular risk factors. If the authors had considered the above mentioned confounding factors, they would perhaps have found different results.
References
- 1.Ocak T, Erdem A, Duran A, et al. The importance of the mean platelet volume in the diagnosis of supraventricular tachycardia. Afr Health Sci. 2013;13(3):590–594. doi: 10.4314/ahs.v13i3.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract. 2009;63(10):1509–1515. doi: 10.1111/j.1742-1241.2009.02070.x. [DOI] [PubMed] [Google Scholar]
- 3.Varol E, Akcay S, Icli A, et al. Mean platelet volume in patients with prehypertension and hypertension. Clin Hemorheol Microcirc. 2010;45(1):67–72. doi: 10.3233/CH-2010-1327. [DOI] [PubMed] [Google Scholar]
- 4.Varol E, Aksoy F, Bas HA, Ari H, Ozaydin M. Mean Platelet Volume is Elevated in Patients With Low High-Density Lipoprotein Cholesterol. Angiology. 2013 Sep 23; doi: 10.1177/0003319713504024. [DOI] [PubMed] [Google Scholar]
- 5.Atalar E, Haznedaroglu IC, Acil T, et al. Patients with paroxysmal atrial fibrillation but not paroxysmal supraventricular tachycardia display evidence of platelet activation during arrhythmia. Platelets. 2003;14(7–8):407–411. doi: 10.1080/09537100310001638814. [DOI] [PubMed] [Google Scholar]