SHORT COMMUNICATIONMean platelet volume in patients with ischemic heart disease: meta-analysis of diagnostic studiesLippi, Giuseppea; Mattiuzzi, Camillab; Comelli, Ivanc; Cervellin, GianfrancocAuthor Information aUnità Operativa Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Parma bServizio Governance Clinica, Ospedale di Trento, Trento cUnità Operativa Pronto Soccorso e Medicina d’Urgenza, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy Correspondence to Professor Giuseppe Lippi, U.O. Diagnostica Ematochimica, Azienda Ospedaliero-Universitaria di Parma, Via Gramsci 14, 43126 Parma, Italy Tel: +39 0521 703050/39 0521 703197; e-mail: firstname.lastname@example.org,email@example.com Received 13 August, 2012 Revised 26 September, 2012 Accepted 1 October, 2012 Blood Coagulation & Fibrinolysis: March 2013 - Volume 24 - Issue 2 - p 216-219 doi: 10.1097/MBC.0b013e32835b2450 Buy Metrics Abstract It is now widely acknowledged that larger platelets are biologically more active and express a greater prothrombotic potential, but there is no definitive evidence on the diagnostic accuracy role of mean platelet volume (MPV) in patients with ischemic heart disease. We performed an electronic search for articles that have assessed the diagnostic accuracy of MPV in patients admitted at the emergency department with a suspected diagnosis of ischemic heart disease, including articles in which the exact number of true-positive, false-positive, false-negative and true-negative test results could be either directly or indirectly extracted. Heterogeneity was assessed by I2 test. The cumulative estimates and 95% confidence interval (95% CI) of sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), area under the receiver operator characteristic (ROC) curve (AUC) and diagnostic odds ratio (DOR) were calculated using a random effect model. Three studies were finally included in our analysis (mean quality score, 10.8) totaling 3577 participants (566 cases and 3011 controls). The between-study variation was high (I2, 96.2%; P < 0.001). The pooled estimates were 0.820 (95% CI 0.786–0.851) for sensitivity, 0.461 (95% CI 0.443–0.479) for specificity, 0.932 (95% CI 0.918–0.944) for NPV and 0.222 (95% CI 0.205–0.241) for PPV and 0.652 (95% CI 0.596–0.707) for AUC. The DOR was 3.9 (95% CI 2.3–6.5), with 0.52 diagnostic accuracy. The outcome of this meta-analysis suggests that MPV does not meet the requirements for efficient triage of patients in emergency department when used as stand-alone test, whereas its combination with high-sensitive troponin immunoassays merits further investigations. © 2013 Lippincott Williams & Wilkins, Inc.