Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 12 1 2020 02 21 Prognostic value of platelet indices in patients with acute pulmonary thromboembolism 56 62 10.34172/jcvtr.2020.09 EN Samad Ghaffari https://orcid.org/0000-0001-6806-9387 Nashmil Parvizian Leili Pourafkari https://orcid.org/0000-0002-3863-192X Ahmad Separham Reza Hajizadeh Nader D Nader https://orcid.org/0000-0002-5744-7319 Elnaz Javanshir Nariman Sepehrvand Arezou Tajlil Babak Nasiri Journal Article 10.34172/jcvtr.2020.09 2019 04 22 2020 01 24 Introduction: Given the role of platelets in thrombus formation, markers of platelet activation may be able to predict outcomes in patients with acute pulmonary thromboembolism (PTE). Methods: In a prospective cohort study, 492 patients with acute PTE were enrolled. Patients were evaluated for platelet indices including mean platelet volume (MPV), platelet distribution width (PDW), and platelet-lymphocyte-ratio (PLR), as well as for the simplified Pulmonary Embolism Severity Index (PESI) risk score. The primary endpoint was in-hospital all-cause mortality. Major adverse cardiopulmonary events (MACPE, composite of mortality, thrombolysis, mechanical ventilation and surgical embolectomy during index hospitalization) and all-cause death during follow-up were secondary endpoints. Results: MPV, PDW and PLR were 9.9±1.0 fl, 13.5±6.1%, and 14.7±14.5, respectively, in the total cohort. Whilst MPV was higher in those with adverse events (10.1±1.0 vs 9.9±1.0 fl; P = 0.019), PDW and PLR were not different between two groups. MPV with a cut-off point of 9.85 fl had a sensitivity of 81% and a specificity of 50% in predicting in-hospital mortality, but it had lower performance in predicting MACPE (Area under the curve: AUC 0.58; 95%CI 0.52-0.63) or long-term mortality (AUC 0.54; 95% CI 0.47-0.61). The AUC for all these three markers were lower than the AUC calculated for the simplified PESI score (0.80; 0.71-0.88). Conclusion: Platelet indices had only fair-to-good predictive performance in predicting in-hospital all-cause death. Established PTE risk scoring models such as simplified PESI outperform these indices in predicting adverse outcomes.